Ovarian Cystectomy Surgery

Introduction

Surgeons perform ovarian cystectomy, a surgical operation in which they resect cysts from 1 or both ovaries, retaining the ovaries as a surgical structure. Ovarian cysts are sacs of fluid that may arise either on or in the ovaries. Whereas most ovarian cysts are insignificant and resolve incidentally, some ovarian cysts may cause symptoms such as pain, bloating, or even abnormal menstrual cycles and thus might necessitate surgical intervention.

Ovarian cystectomy is a salpingectomy that has a fertility-preserving nature and is a good choice for the biological age of women. Recent achievements of minimally invasive procedures have rendered the process safer (shorter period of recovery and no pain).

What is Ovarian Cystectomy?

Surgeons perform ovarian cystectomy to resect ovarian cysts while leaving intact ovarian parenchyma behind. This protocol is, in general, recommended for women with symptomatic, large, or refractory ovarian cysts or suspected of malignancy.

Common types of ovarian cysts include: 

• Functional Cysts: Related to the menstrual cycle and often harmless.
• Dermoid Cysts: Contain tissues like hair, skin, or teeth.
• Endometriomas: Caused by endometriosis and filled with thick, dark blood.
• Cystadenomas: Fluid-filled cysts that develop on the ovary’s surface.
• Polycystic Ovaries: Multiple small cysts associated with polycystic ovary syndrome (PCOS).

Why is Ovarian Cystectomy Needed?

An ovarian cystectomy may be recommended for women experiencing:

• Severe Pelvic Pain: Caused by large or ruptured cysts.
• Persistent or Growing Cysts: Irreducible cysts that fail to resolve spontaneously over a couple of menstrual cycles.
• Suspected Malignancy: Cysts that appear cancerous on imaging or lab tests.
• Infertility: Cysts interfering with ovulation or fertility.
• Irregular Menstrual Cycles: Caused by hormonal imbalances due to cysts.
• Complications: Twisting or rupturing of a cyst into acute symptoms.

Types of Ovarian Cystectomy Procedures

Laparoscopic Ovarian Cystectomy: 

• A microscopic, minimally invasive approach using relatively small incisions, through the help of a video camera (laparoscope) for guidance.
• Suitable for most benign cysts.

Open Ovarian Cystectomy (Laparotomy): 

• It requires an extensive abdominal incision and is typically performed for giant or suspicious cysts.

Robotic-Assisted Cystectomy:

• An extremely precise technique that uses robotic devices to improve the precision and the smallest possible tissue ablation.

Cyst Aspiration:

• Cyst contents are drained, but this is usually reserved for either relief of symptoms or diagnostic applications alone.

Procedure Steps

1. Pre-Surgery Evaluation:

• Pelvic Ultrasound: To determine the size, location, and type of cyst.
• Blood Tests: Includes CA-125 levels to rule out ovarian cancer.
• Medical History: Review of symptoms, menstrual cycle, and fertility goals.

2. Anesthesia:

• General anesthesia is used to induce patient sedation during the procedure.

3. Surgical Process:

• Laparoscopic Approach:

• • The surgeon makes small incisions in the abdomen.
  • A surgeon inserts a laparoscope to locate the cyst.
  • The surgeon releases the cyst with minimal tissue trauma to the ovary and removes it.

• Laparotomy:
  • For the introduction and excision of the cyst, a larger incision is created to facilitate the procedure, especially if malignancy is suspected.

4. Closure:

• Incisions are closed with sutures or fixed by surgical glue and dressings are put on.

5. Post-Surgery Monitoring:

• Postoperative pain, hemorrhage, and postoperative symptoms such as these are controlled for the patient.

Benefits of Ovarian Cystectomy

• Relief Symptoms: Alleviates pain, bloating, and discomfort caused by cysts.
• Preserves Fertility: Retains healthy ovarian tissue for future reproduction.
• Minimally Invasive Options: Experiencia laparoscópica e robótica ofrece una mejor recuperación postoperatoria y una menor cicatrización posoperatoria.
• Prevents Complications: Reduces the risk of cyst rupture, torsion, or malignancy.
• Improved Quality of Life: Resolves symptoms and restores hormonal balance.

Cost of Ovarian Cystectomy in India

• United States: $8,000 – $20,000 
• United Kingdom: $7,000 – $15,000 
• Thailand: $3,500 – $8,000 
• India: $2,000 – $5,000 

Best Hospitals in India for Ovarian Cystectomy

India offers world-class facilities for ovarian cystectomy. Notable hospitals include:

Metro Hospital Faridabad:

• Specializes in advanced laparoscopic gynecological surgeries.
• Known for experienced surgeons and state-of-the-art infrastructure.

Fortis Healthcare (Delhi): 

• A place of international fame in minimally invasive gynecologic operations with superb outcomes.

Max Healthcare (Delhi):

• Offers comprehensive gynecological care with cutting-edge technology.

Risks and Complications

While ovarian cystectomy is generally safe, potential risks include:

• Infection: Preventable with proper postoperative care.
• Bleeding: Rare but may occur during or after surgery.
• Scar Tissue Formation: Adhesions may develop, affecting fertility in rare cases.
• Damage to Ovarian Tissue: Minimal risk with skilled surgical techniques.
• Cyst Recurrence: New cysts may form in the future.

Recovery

Immediate Recovery:

• Hospital Stay: Normal ranges are 1-2 (lapping) days and 3-5 (flat) days.
• First Week: Mild discomfort, bloating, and fatigue are common. Pain medications and rest are essential.

Long-Term Recovery:

• 2-4 Weeks: Most patients are discharged after light activity and work with minimally invasive surgery.
• 6-8 Weeks: Complete recovery to open surgery and clearance for heavy work.
• Follow-Up Care: Regular check-ups ensure proper healing and monitor for recurrence

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