January 15, 2017 Liza Colimon, MD An Ovarian Cystectomy is a surgical procedure performed to remove a cyst in the ovary. A cyst is a closed sac with fluid or contents inside. There are many types of Ovarian Cysts. The most common Types are: Functional Cysts caused by ovulation Hemorrhagic Cysts Endometriosis Containing Cysts/Endometriosis Dermoid Cysts Germ Cell Tumors Indications for Ovarian Cystectomy Why would you need to have a cyst removed from your ovary? If you are experiencing one of the following: Persistent Pain Sudden Nausea or Vomiting Sudden Sharp Pain that does not improve An Ovarian Cyst that keeps Growing Endometriosis Infertility Surgical Approaches to Ovarian Cystectomy Laparoscopic Ovarian Cystectomy Robotic Assisted Laparoscopic Ovarian Cystectomy Abdominal Ovarian Cystectomy Laparoscopic Ovarian Cystectomy An ovarian cyst is a fluid filled pocket within the skin of ovary which typically results from ovulation. Ovarian cysts often cause discomfort, pain or bloating. They typically resolve on their own after breaking but occasionally they persist and may grow large. Ovarian cysts are a usually the outcome of a normal process during the menstrual cycle when the ovary is getting prepared to ovulate. Ovarian cysts often break on their own and new cysts can form on either ovary on a monthly basis. If you have a cyst that is not going away, growing larger, bleeding, or causing pain, you may need to have it removed. A Laparoscopic Ovarian Cystectomy is a type of minimally invasive surgery in which small incisions between 0.5 to 1 cm are made on the abdominal wall (belly) through which an instrument called a laparoscope can be placed. The laparoscope allows the surgeon to see inside the abdomen and pelvis. The abdominal cavity is filled with an absorbable gas, typically, carbon dioxide to allow space for the surgeon to see and remove the cyst by cutting it free from the ovarian wall. Small instruments are placed through the small incisions allowing the surgeon to remove an ovarian cyst while leaving most of the remaining ovary intact which is essential for fertility. Draining it alone by puncturing a whole in it often times will not cure the cyst. Depending on the type of cyst one has, they often grow back within weeks to months. Patients must receive general anesthesia during the procedure and typically go home the same day. The advantages of laparoscopy over traditional abdominal surgery to perform an ovarian cystectomy include a shorter post-operative hospital stay, a shorter recovery interval and less pain. Also since smaller instruments are used, more ovarian tissue can be preserved and scarring can be minimized. Abdominal Ovarian Cystectomy An Abdominal Ovarian Cystectomy is the removal of and ovarian cyst from an open abdominal incision (cut on the belly). Abdominal surgery requiring larger incisions is referred to as a Laparotomy incision. The size and location of the incision will depend on the size and number of ovarian cysts that are present. The abdominal approach is usually reserved for patients with a very large ovarian cyst or when the surgeon is concerned about the appearance of the cyst. If the cyst has grown very large, has solid parts to it, or has an appearance that looks worrisome or suspicious for cancer then the surgeon may decide to take out the cyst with a cut on the abdomen to avoid breaking the cyst open and spilling the contents inside the abdomen.