Page 64 - World Journal of Laparoscopic Surgery

A Laparoscopic Approach of a Very Large Ovarian Cyst in Young Female

Fig. 2: Patient under general anesthesia (GA)
Fig. 5: Large ovarian cystic fluid

Fig. 3: Laparoscopic view of large ovarian cyst
Fig. 6: Adhesions between the urinary bladder and large ovarian cyst
wall urinary bladder filled with saline
The ovarian cyst was removed after enlarging the left iliac fossa
working port to 3–4 cm to remove an ovarian cyst in small pieces.
Extracting such a large ovarian cyst through a small incision requires
a lot of patience, zigzag movement helps in early extraction.
Specimen send for histopathological examination (Fig. 7).
No bowel and bladder injury was encountered during surgery.
The left side ovary and fallopian tube are normal. Through wash
given using 8–10 L of normal saline. Drain placed in the pelvis (Fig. 8).
The Postoperative patient extubated her vitals were stable.
Postoperative day-1 Hb—9.7 g drain was 600 mL vitals were
normal with good urine output. The patient started on liquids
after 8 hours of surgery and proceed to a soft diet for the next
24 hours. The postoperative day-2 drain was 400 mL vitals were
stable with good urine output and the patient was ambulant
tolerating oral soft diet. On postoperative day-2, the patient was
discharged with drain and Foley’s catheter. The patient called
Fig. 4: Ovarian fluid aspiration using a suction catheter for a review on postoperative day-5 her drain was 60 mL serous
(day-3—280 mL, day-4—120 mL) urine output was good 2 L plus in
bladder was filled with 500 mL of saline meticulous dissection was 24 hours. Both drain and Foley’s were removed on postoperative
done and slowly proceeded. Ovarian cyst wall dissected from the day-5. Postoperative day-12 all sutures were removed as Figure 9.
urinary bladder (Fig. 6). Histopathology report: benign serous cystadenoma.

62 World Journal of Laparoscopic Surgery, Volume 15 Issue 1 (January–April 2022)