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Laparoscopic Cystectomy Done in Late Pregnancy


 

LONDON — Laparoscopic cystectomy during late pregnancy is a safe alternative to laparotomy or expectant management of large cysts, according to the results of a small case series presented at the annual congress of the International Society for Gynecologic Endoscopy.

“Although most (ovarian)cysts resolve spontaneously, large cysts can present a risk of torsion or rupture and also may cause malpresentation or labor dystocia,” commented Saurabh Phadnis, M.D., of Watford (England) General Hospital.

In addition, about 2%-5% of the cysts that appear during pregnancy are actually malignant, according to Dr. Phadnis.

He said that his surgical team performed laparoscopic cystectomy in six women whose pregnancies were between 21 and 30 weeks' gestation.

Each of the women had large cysts, measuring 8ndash;12 cm. Their surgical procedures were reported to have lasted no more than 40 minutes.

Three of the cysts were mature teratomas, two were mucinous cystadenomas, and one cyst was a serious cystadenoma.

There were no surgical complications reported, and all of the patients went home the following day except one who went home on the second day after the procedure.

Obstetric outcomes were considered normal for each of the patients, with spontaneous vaginal deliveries at term for every woman, except one patient who had requested to have a cesarean section delivery at 39 weeks' gestation.

This patient has an 8-cm ovarian cyst and 28-week gravid uterus.

The cyst is dissected off the ovarian tissue, using laparoscopic scissors.

Healthy tissue is left after the removal of the ovarian cyst. Photos courtesy Dr. Saurabh Phadnis

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