This study was undertaken to evaluate the clinical usefulness of operative laparoscopy in treatment of benign ovarian cysts. A retrospective study was carried on 468 operative laparoscopy cases performed from September 1995 to September 1998 at Yonsei University College of Medicine, Department of Obstetrics and Gynecology. Patient characteristics, specimen pathology, perioperative morbidity, and perioperative complications were reviewed. The percentage of operative laparoscopy increased steadily from 20.7% in 1996, 33.9% in 1997, to 49.7% in 1998. The mean age of patients was 33.66.5 (mean +/- SD) years and the mean hospital stay was less than 2 days. Types of surgery performed were cystectomy (n = 234), salpingo-oophorectomy (n = 126), oophorectomy (n = 63), and fulguration (n = 45), in decreasing order. Depending on the pathology of the ovarian cyst, the mean operation time was in the range of 80 to 110 minutes. Perioperative complications included 5 cases of subcutaneous emphysema, 10 cases of abdominal wall hematoma, 7 cases of trocar site bleeding, 3 cases of bowel injury, and 1 case of bladder injury. In conclusion, operative laparoscopy in treating benign ovarian cysts provides advantages such as less need to perform laparotomy, smaller skin incision, less perioperative discomfort, minimal tissue handling and trauma, and shorter hospital stay. Nevertheless, the risk of unrecognized ovarian malignancy cannot be absolutely excluded, therefore careful patient selection is mandated.
Adolescence ; Adult ; Child ; Female ; Human ; Laparoscopy* ; Laparotomy ; Middle Age ; Ovarian Cysts/ultrasonography ; Ovarian Cysts/surgery*

Female ; Humans ; Laparoscopy ; Ovarian Cysts/surgery* ; Pregnancy ; Pregnancy Trimester, Third ; Torsion Abnormality/surgery*

Adult ; Female ; Humans ; Laparoscopy ; adverse effects ; Ovarian Cysts ; surgery ; Ovariectomy ; adverse effects ; Pregnancy ; Takotsubo Cardiomyopathy ; etiology

OBJECTIVETo evaluate the efficacy of improved laparoscopic enucleation of benign ovarian cysts.

METHODSA total of 234 cases of ovarian cysts with 271 cysts were analyzed retrospectively. 152 patients with 177 ovarian cysts (Group A) underwent the improved laparoscopic enucleation and 82 patients with 94 ovarian cysts (Group B) underwent the classic laparoscopic enucleation. The data of operative process and postoperative follow-up were compared between two groups.

RESULTSThe rate of spillage of the Group A and Group B was 1.7% and 18.1% (P<0.01), respectively. The operating time was (40 +/-14)min and (47 +/- 16)min (P<0.01), respectively. The blood loss was (25 +/-17)ml and (27 +/- 19)ml (P>0.05), respectively. The bowel deflation recovery time was (18 +/- 8)h and (19 +/- 8)h (P>0.05), respectively. The length of hospital stay was (2.0 +/- 0.5)d and (2.2 +/- 0.8)d (P>0.05), respectively.

CONCLUSIONCompared with classic laparoscopic procedure, the improved laparoscopic ovarian enucleation seems to be safer and more effective with shorter operating time.

Adolescent ; Adult ; Female ; Humans ; Laparoscopy ; methods ; Middle Aged ; Ovarian Cysts ; surgery ; Retrospective Studies

OBJECTIVETo evaluate the surgery in simple ovarian cysts.

METHODSFrom Jan. 1994 to Dec. 1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was < 5 cm in 76 cases, and was > or = 5 cm in 145 cases ultrasonically. One hundred and eighty-four patients underwent laparoscopy, and thirty-seven underwent laparotomy.

RESULTSHistological findings showed no malignancy in this series. Simple cysts, paraovarian cysts and corpus luteum were found histologically in 90.8% of cases with cysts < 5 cm, and 60% of those with cysts > 7 cm respectively, their difference was significant (chi2=37.13, P<0.001). The simple cysts, paraovarian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of premenopausal women.

CONCLUSIONPatients with cysts > 7 cm are indicated for surgical procedures, while a period of followup is acceptable for patients with cysts < 7 cm, and surgery is advisable if the cyst is persistent during followup. Postmenopausal women with cysts should have operations.

Endometriosis ; diagnostic imaging ; surgery ; Evaluation Studies as Topic ; Female ; Humans ; Laparoscopy ; Laparotomy ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovarian Diseases ; diagnostic imaging ; surgery ; Ovarian Neoplasms ; diagnostic imaging ; surgery ; Teratoma ; diagnostic imaging ; surgery ; Ultrasonography

INTRODUCTIONThe purpose of this case series was to determine the sonographic features of neonatal ovarian torsion.

MATERIALS AND METHODSSeven surgically proven cases of neonatal ovarian cysts were included in this retrospective study. The patients were divided into 2 groups, torsion and non-torsion. These 7 patients were evaluated for the clinical presentation, sonographic features, surgical and pathological findings. The findings on follow-up sonography after surgery were also noted.

RESULTSThe sonographic appearance was variable. Of the 4 cases with torsion, 2 lesions had internal echoes with 'fi sh-net appearance'. The other 2 lesions were predominantly cystic on the sonography with internal echoes and echogenic nodule. A calcific focus was present in 1 of these echogenic nodules. One of the cysts had fluid-fluid level. In the non-torsion group, only 1 lesion had mixed echogenic appearance. The other 2 lesions were cystic with low level internal echoes in 1 of the cysts. The surgical procedure performed in the torsion group was salpingo-oophorectomy in 2 patients and oophorectomy in 1 patient. In 1 patient, cystectomy was attempted without success. In the non-torsion group, only cystectomy was performed with preservation of normal ovaries, which was confirmed on follow-up sonography.

CONCLUSIONThe sonographic features of cysts with 'fish-net appearance', fluid-debris level and cysts with echogenic nodule favour torsion. The former sign has so far not been described as a sonographic predictor for neonatal ovarian torsion.

Female ; Humans ; Infant, Newborn ; Ovarian Cysts ; diagnostic imaging ; pathology ; surgery ; Ovary ; diagnostic imaging ; pathology ; Postoperative Period ; Retrospective Studies ; Torsion Abnormality ; diagnostic imaging ; pathology ; surgery ; Ultrasonography, Doppler ; instrumentation

Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Fetal ovarian cyst often presents complication such as torsion and seems to be an indication for surgical intervention. In this study, we reviewed pre- and post-natal medical records and ultrasonography of 17 fetuses that were diagnosed with ovarian cysts. In a total of 17 cases, postnatal surgery was performed in 7 infants. Of these cases, four cases of ovarian cyst torsion were confirmed. In the remaining 10 fetuses, one case regressed completely during pregnancy, and the other nine cases including two complex cysts resolve spontaneously after birth. Postnatal symptomatic cysts or cysts with a diameter greater than 5 cm that do not regress or enlarge should be treated, but uncomplicated asymptomatic cysts less than 5 cm in diameter should only be observed and reassessed by serial ultrasonography. If they regress spon-taneously, no surgical intervention is necessary independent of their sonographic findings.
Ultrasonography, Prenatal/*methods ; Remission, Spontaneous ; Pregnancy ; Ovariectomy/methods ; Ovarian Cysts/*diagnosis/surgery ; Infant, Newborn ; Infant ; Humans ; Gestational Age ; Fetal Diseases/*diagnosis/surgery ; Female

Laparoscopy is a surgical procedure used both for diagnosis and for various treatments. A rare but sometimes fatal complication of laparoscopy is pulmonary embolism with CO2 resulting in pulmonary edema. During laparoscopic gynecological surgery in a 29-year-old woman who had previously undergone lower abdominal surgery, the end-tidal CO2 suddenly increased from 40mmHg to 85mmHg and then decreased to 13mmHg with hemodynamic deterioration. These events are characteristic of a CO2 embolism. When this occurred, CO2 insufflation was immediately stopped and the patient was resuscitated. The patient's condition gradually improved with aggressive treatment, but the clinical course was complicated by bilateral pulmonary edema. This case of pulmonary edema was soon resolved with supportive management. The formation of a CO2 embolism during laparoscopy must be suspected whenever there is a sudden change in the end-tidal CO2. In addition, the possibility of pulmonary edema should be considered when a CO2 embolism occurs.
Adult ; Carbon Dioxide/*metabolism ; *Cystectomy ; Female ; Humans ; *Laparoscopy ; Ovarian Cysts/*surgery ; Pulmonary Edema/*complications/metabolism/radiography ; Pulmonary Embolism/*complications/metabolism/radiography

Abscess ; surgery ; Adult ; Aged ; Aged, 80 and over ; Cysts ; surgery ; Drainage ; methods ; Endometriosis ; surgery ; Fallopian Tube Diseases ; surgery ; Female ; Humans ; Middle Aged ; Ovarian Cysts ; surgery ; Pelvis ; surgery ; Retrospective Studies ; Surgery, Computer-Assisted ; Tertiary Care Centers ; Treatment Outcome ; Ultrasonography ; Ultrasonography, Interventional ; methods ; Vagina ; Young Adult

Adnexa Uteri ; surgery ; Colectomy ; methods ; Colonic Diseases ; etiology ; pathology ; surgery ; Colostomy ; Endometriosis ; complications ; pathology ; surgery ; Female ; Fistula ; etiology ; pathology ; surgery ; Follow-Up Studies ; Humans ; Intestinal Fistula ; etiology ; pathology ; surgery ; Middle Aged ; Ovarian Cysts ; complications ; pathology ; surgery ; Ovarian Diseases ; etiology ; pathology ; surgery ; Ovariectomy