Laparoscopic Cystectomy In-a-Bag of an Intact Cyst: Is It Feasible and Spillage-Free After All?
This prospective study was conducted to assess the feasibility of laparoscopic cystectomy of an intact adnexal cyst performed inside a water proof endoscopic bag, aiming to avoid intraperitoneal spillage in case of cyst rupture. 102 patients were recruited. Two of them were pregnant. In 8 of the patients the lesions were bilateral, adding up to a total of 110 cysts involved in our study. The endoscopic sac did not rupture in any case. Mean diameter of the cysts was 5.7 cm (range: 2.3-10.5 cm). In 75/110 (68.2%) cases, cystectomy was completed without rupture, whereas in the remaining 35/110 (31.8%) cases the cyst ruptured. Minimal small spillage occurred despite every effort only in 8/110 (7.2%) cases with large (>8 cm) cystic teratomas. There were no intraoperative or postoperative complications. We concluded that laparoscopic cystectomy in-a-bag of an intact cyst is feasible and oncologically safe for cystic tumors with a diameter < 8 cm. Manipulation of larger tumors with the adnexa into the sac may be more difficult, and in such cases previous puncture and evacuation of the cyst contents should be considered.
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Stelios
S
Detorakis
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Dimitrios
D
Vlachos
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Stavros
S
Athanasiou
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Themistoklis
T
Grigoriadis
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Aikaterini
A
Domali
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Ioannis
I
Chatzipapas
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Emmanuel
E
Stamatakis
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Athanasios
A
Mousiolis
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Apostolos
A
Patrikios
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Aris
A
Antsaklis
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Dimitrios
D
Loutradis
1st Department of Obstetrics and Gynecology of the University of Athens, Alexandra Hospital, 80 Queen Sophie Avenue and Lourou Street, 11528 Athens, Greece.
Athanasios
A
Protopapas