Laparoscopic Management of Ovarian Dermoid Cyst
Mature cystic teratomas is one of the common ovarian pathology is female of reproductive age group. Ovarian teratoma is often referred to as dermoid cysts. Dermoid cyst are the most common germ cell tumors of the ovary. Histologically, dermoid cysts contain different tissues developed from one or all three germinative layers. The most commonly observed are tumors of ectodermic tissue.
In the recent years of new diagnostic modalities, transvaginal sonographic diagnosis of ovarian dermoid cysts together with laparoscopic approach have greatly improved the treatment of this benign lesion. Experienced laparoscopic surgeons should consider laparoscopy as an alternative to laparotomy in management of ovarian dermoid cysts in selected cases.
In most of the cases laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon. The risk of chemical peritonitis can be minimized when undertaking laparoscopic removal of ovarian dermoid cysts if the peritoneal cavity is washed out thoroughly from spillage of cyst contents. Drainage of peritoneal cavity should be performed in the patients with the ruptured dermoid cysts.
The risk of granulomatous peritonitis can be minimized by undertaking laparoscopic removal of dermoid cysts with the routine intraoperative use of an endoscopic retrieval bag to prevent intraperitoneal spillage of cysts contents. The spilled contents should be aspirated from the peritoneal cavity as soon as possible since it can cause development of chemical peritonitis. Spilled fluid from ovarian dermoid cysts should be removed as soon as possible from the peritoneal cavity in order to prevent prolonged chemical peritonitis.
Nowadays Laparoscopic or robotic surgery should be considered as a method of choice for the removal of ovarian dermoid cysts in female. It should be performed by minnnnnnimal access surgeons with considerable experience in advanced laparoscopic surgery. All the experienced laparoscopic surgeons or gynecologists should consider minimally invasive surgery as an alternative to laparotomy in management of ovarian teratoma. We concluded that the suggested big risk of chemical peritonitis is unnecessary and risk of chemical peritonitis can be every easily minimized when undertaking the laparoscopic removal of ovarian dermoid cysts and if the peritoneal cavity is thoroughly washed out by normal saline rom spillage of cysts contents often called as copious lavage.
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