Page 52 - WJOLS - Journal of Laparoscopic Surgery

WJOLS
WJOL S

10.5005/jp-journals-10033-1321
Management of Ovarian Dermoid Cyst and Highlight on Chemical Peritonitis
RevieW ARticLe

Management of Ovarian Dermoid Cyst and Highlight

on Chemical Peritonitis

Priyanka Shekarappa

ABSTRACT Ultrasound Findings
Mature cystic teratomas or dermoid cysts, most common • Presence of a Rokitansky nodule—densely echogenic
among germ cell tumors of ovary, contribute to 70% of benign tubercle projecting into the cyst lumen
neoplasms affecting women of age group less than 30 years.
Mature cystic teratomas or dermoid cysts are most commonly • Fat fluid levels
mistaken for malignancy in ultrasound. • Dermoid mesh sign—matrix of echogenic bands made
by hair fibers floating within the cyst
Keywords: Chemical peritonitis, Dermoid cysts, Laparoscopy,
Tissue retrieval techniques. • Tip of the iceberg sign—acoustic shadowing the
sebum can have on hair-containing lesions 2
How to cite this article: Shekarappa P. Management of
Ovarian Dermoid Cyst and Highlight on Chemical Peritonitis.
World J Lap Surg 2017;10(3):133-134. Choices in Surgical Treatment:
Source of support: Nil Laparoscopy or Laparotomy
Conflict of interest: None Most of the trials reported laparoscopy is superior to
laparotomy and considered to be the gold standard in
AIMS AND OBJECTIVES the management of dermoid cysts (RCOG level 1). 1,3-6
Advantages of laparoscopic removal of dermoid cysts:
• Diagnosis of dermoid cyst • Better magnification, more precise, less injury to
• Choices in surgical treatment—laparoscopy or lapa- ovarian tissue
rotomy • Less bleeding
• Oophorectomy or ovarian cystectomy • Less adhesion
• Tissue retrieval techniques • Less postoperative pain
• Prevention of spillage of cyst contents during cystec- • Shorter hospital stay
tomy and management of consequences if rupture • Cosmetically better scar
occurs • Cost-effective due to shorter hospital stay, less post-
operative narcotics, and early return to work
MATERIALS AND METHODS
Disadvantages:
Sources from PubMed, Royal College of Obstetricians and • Longer duration of surgery
Gynecologists (RCOG) guidelines, search on literature • Requires expertise
from articles published between 1998 and 2016. • Chances of rupture

RESULTS Laparoscopic Oophorectomy

Diagnosis of Dermoid Cysts or Ovarian Cystectomy
According to RCOG guidelines, a pelvic ultrasound is Cystectomy is considered the first procedure of choice
the single most effective way of evaluating ovarian mass as it affects women of reproductive age group. In post-
with TVS being preferable. 1 menopausal women, oophorectomy is the procedure of
choice. 1,7

Consultant
Tissue Retrieval Techniques
Department of Obstetrics and Gynecology, Motherhood Hospital
Bengaluru, Karnataka, India • Minilaparotomy
Corresponding Author: Priyanka Shekarappa, Consultant • Endobag
Department of Obstetrics and Gynecology, Motherhood Hospital • Colpotomy
Bengaluru, Karnataka, India, e-mail: drpriyankamadhu@gmail. Commercially available endobags are considered to
com
be superior over other two techniques. 4
World Journal of Laparoscopic Surgery, September-December 2017;10(3):133-134 133