How to remove a large ovarian cyst. Ovarian cyst: dangerous and normal sizes for surgery

In women, cavities filled with fluid may form on the surface or inside the ovary. Is it necessary to remove a cyst after detection, and can a cyst be dangerous for women's health? This largely depends on the reasons for the development of education, as well as on its structure and localization. The final decision on how to get rid of an ovarian cyst is made by the doctor after a series of diagnostic measures.

In this article we will talk about what features the removal of an ovarian cyst has and what methods are used to perform the operation.

If they are single and have a small diameter (especially if the patient is in menopause), a wait-and-see approach is used. Over the course of several menstrual cycles ovarian cyst is treated by specialists conservative method. The patient is prescribed hormonal birth control pills, vitamin complexes, and symptomatic treatment. Also, the treatment regimen is often supplemented with suppositories for cysts.

While the patient is being treated medications, she should be under constant supervision of the attending physician. In addition, it is necessary to undergo ultrasound regularly. This will help monitor the dynamics of the disease and reliably determine whether it will be necessary to remove the ovarian cyst.

If after three months from the start of conservative treatment the formation has resolved, then surgery to remove the ovarian cyst is not necessary. However, if there is no improvement, and there is no likelihood that the formation will disappear on its own, surgical intervention is recommended. When there is a threat of complications (for example, spontaneous or torsion of its legs) or an ovarian cyst large sizes

– for operations this is also considered a direct indication.

When is surgery prescribed? Experts recommend surgical treatment of formations on the ovaries in many cases. So, for example, dermoid, mucinous and formations must be removed. Surgically

It should be noted that tumor removal can be planned or emergency. In most cases, operations are planned in advance, as this allows time for preliminary preparation of the patient. When an ovarian cyst is diagnosed, emergency treatment is prescribed if there is a threat to life or health, or is unbearable. sharp pain. More often emergency surgery performed on a cyst is more severe than planned interventions. In addition, in addition to the education itself, doctors often also have to remove the ovary or even the uterus.

The method for treating ovarian cysts is selected individually. First of all, the woman’s age and whether she plans to become pregnant in the future are taken into account. If we're talking about about a young patient for whom it is important to preserve reproductive function, then in the question of how to treat an ovarian cyst, preference is given to operations that allow preserving organs (when possible). While preserving the uterus and ovary during menopause is almost impossible. Extirpation of the uterus and appendages is necessary to avoid complications. This type of surgery is also performed to prevent the development of oncological diseases organs of the reproductive system.

Laparotomy of ovarian cyst

Basic methods of surgery

Today, specialists have several options for how to remove an ovarian cyst:

1. . The classic solution is abdominal surgery. It is recommended for large tumors, rupture or torsion, or if the development of a malignant process is suspected. Laparotomy of the ovarian cyst is performed by making an incision in the anterior wall of the abdominal cavity. This way the specialist gets open access to the affected area. Abdominal surgery, in addition to removing an ovarian cyst, also makes it possible to completely or partially remove the ovary. Sometimes surgical intervention is carried out after the uterus and its appendages have been excised.

After laparotomy, a woman is not able to quickly return to her normal lifestyle. Recovery after abdominal removal of an ovarian cyst lasts at least two weeks. Also on a long period limited ability to work remains. In addition, after surgery to remove an ovarian cyst, secondary complications may occur.

Laparoscopy

1. . Laparoscopic removal of a tumor involves creating several punctures in the lower abdominal cavity through which metal tubes with a video camera and surgical instruments can pass. Using them, the doctor removes the cyst. Healthy tissue reproductive organs there are no injuries. Consequently, in the future, enucleation (as is also called this procedure), will not have a negative impact on the patient’s reproductive function.

After the cyst is removed, cosmetic stitches and bandages are applied to the incisions. Already on the same day, women are allowed to get out of bed, and on the third day after laparoscopy of the ovarian cyst they are discharged home. The recovery period most often does not cause any pain or anxiety.

1. Laser. Laser cyst removal is considered faster and more accurate than the previous method. How does the operation proceed in this situation? The resection instrument is not a scalpel, but laser ray. The main advantage of this surgical option is the minimal likelihood that bleeding may occur. The laser not only acts as a tool to remove the formation, but also immediately cauterizes the blood.

Regardless of the method surgical intervention, tissues and contents that contained the removed element inside are sent for histological examination. This will help specialists determine the type of formation, as well as determine what medications will be required for further treatment.

Laser cyst removal

Preparing for surgery

With an ovarian cyst that has indications for removal, a woman requires a thorough examination. When surgical treatment of an ovarian cyst is planned, first of all, the following are prescribed:

• fluorography;
• determination of Rh and blood group;
• biochemical and general tests urine and blood;
• research to identify infectious diseases;
• blood clotting study.

7 days before the planned removal of an ovarian cyst through surgery, a woman should make certain adjustments to her diet. It is prohibited to use:

• raw vegetables and fruits;
• all products that may cause increased gas formation;
• fatty foods;
• carbonated drinks;
• rich pastries.

The patient must stop eating at least 10 hours before surgery.. It is also good if it cleanses the intestines first.

Complications and negative consequences

After removal of the formation, various complications of the early postoperative period are possible, for example, wound infection or side effects anesthesia. When using the laparoscopic method of removing an ovarian cyst, Negative consequences after surgery are rare. For example, this could be the consequences of introducing abdominal cavity gas

During the first days after laparoscopy of an ovarian cyst or the use of other operational methods, it is important to closely monitor the patient’s condition. For example, if she is diagnosed heat that does not go away within a few hours after the intervention or postoperative sutures begin to bleed - additional examinations are needed to eliminate the problem.

It is also necessary to say that the removal of a tumor has long-term consequences. For example, there is a possibility of developing adhesive process, which can cause infertility. Even if conception occurs, it is mostly ectopic.

Scars after laparoscopic removal of an ovarian cyst

Features of the recovery period

To avoid the development of an inflammatory process or the formation of adhesions, the woman is prescribed antibiotics after the operation. Patients are also concerned about pain after removal of an ovarian cyst. Therefore, the doctor also prescribes painkillers for them. If there are no significant complications, the sutures can be removed after a week.

After the operation, the patient needs proper rehabilitation. During the recovery period, the doctor gives recommendations regarding temporary adherence to a diet based on the consumption of liquid foods. In addition, it is necessary to limit physical exercise. After laparoscopy of an ovarian cyst or laser removal this will be several weeks, while after laparotomy this period will increase significantly. You also need to abstain from sexual intercourse for at least a month.

It is also worth highlighting the features that further treatment has after removal of an ovarian cyst and regular visits to the gynecologist. Since the specialist has the opportunity to regularly monitor the patient’s condition, he is obliged to tell what the prevention of ovarian cysts should be. In addition, since ovulation soon returns after surgery, the doctor must select the most suitable contraceptive for the coming months.

Important! Conceiving less than 3 years after surgery is highly undesirable.

Surgery and pregnancy

If a pregnant woman learns about the development of formation, it is important for her to know whether an ovarian cyst can be cured before the birth of a child. In addition, expectant mothers are worried about whether the cyst could be dangerous for the baby. It is worth noting that at first the doctor simply prescribes regular ultrasound examinations in order to monitor the dynamics of the development of the formation. He can also choose an “easy” cure for the cyst.

If a specialist sees a deterioration in the patient’s condition, then the question arises as to how to cure an ovarian cyst. If necessary surgical treatment The laparoscopic method is most often used. If the formation is large, laparotomy may be required. However this method intervention is dangerous for both the child and his mother.

Is pregnancy possible after removal of an ovarian cyst? This depends on the characteristics of the operation performed and the extent of removal of the affected tissue. On average, pregnancy occurs in 60-70% of patients. If the ovaries were not removed, then ovulation is restored and conception can be planned within 4-6 months after surgery. However, even after the removal of one of the ovaries, women can ovulate, therefore, there is also a chance of conception. If naturally It is not possible to fertilize the egg - then in vitro fertilization can be used.

Remember! Whatever the removal method cystic formation the doctor did not choose, the main thing is to follow all his prescriptions and adhere to all the rules of the postoperative period!

One of the most common women's diseases is an ovarian cyst. The dimensions for the operation of this formation, as well as its varieties and methods of treatment, will be discussed in this article.

What is a cyst

Nowadays, women with symptoms of ovarian cysts are increasingly turning to a gynecologist. Upon learning of their diagnosis, many panic. However, you shouldn't do this. A cyst is nothing more than a benign formation that is located on the body and tissues of the ovaries. It usually appears when a woman is worried hormonal disbalance. What is this phenomenon? In fact, this is not a tumor, but only a bubble filled with liquid. It has rather thin walls, based on a kind of stem. The dimensions of this cavity can vary: from a few millimeters to twenty centimeters. The larger the bubble, the more likely it is that it will have to be removed. The attending physician will tell the patient at what size of ovarian cyst the surgery is performed, and will also prescribe the necessary treatment.

As a rule, it does not pose any danger if it is diagnosed in time. However, there are known cases of its degeneration into a malignant tumor.

Only a doctor can identify a cyst. The first examination occurs where the doctor sees that the ovaries (or only one of them) have increased in size. After this it will be assigned ultrasonography, which will confirm the doctor’s assumptions.

In addition, it is necessary to take tests for estrogen to understand the reason for the formation of the cyst. It will also be mandatory to be tested for the CA-125 marker. Its indicator will determine whether there is a risk of cancer.

When all the tests are ready, you need to make sure that it is really an ovarian cyst. The woman's symptoms and treatment will be further reviewed by the doctor.

Cyst or not?

Those who first encountered this phenomenon cannot always recognize this disease in themselves.

Typically, the first symptoms that women notice are:

• Pain in the lower abdomen. They can be localized only in one part of it.
• Menstrual irregularities. A delay of a week or more or, conversely, an early arrival of menstruation should alert a woman. Especially if this began to happen regularly.
• Pain during sexual intercourse. The larger the size of the cyst, the more pressure it puts on neighboring organs, causing discomfort.
• Temperature increase. Usually this is a low figure, a little more than 37 degrees.
• Insomnia. Due to hormonal changes, a woman sleeps poorly at night. Especially if there is painful sensations lower abdomen.
• Nausea. One of the most common accompanying symptoms.

Quite often, a right ovarian cyst is confused with acute appendicitis. If her leg is torsioned, then without ultrasound examination these diseases are practically indistinguishable.

Reasons for appearance

Depending on the reason for which the cyst appeared, there are several types of it. However there is General terms appearance of this disease:

• Irregular and early onset menstruation (10-11 years).
• Endocrine disorders.
• Reception hormonal drugs influencing the appearance of cysts.
• Infertility.
• Abuse of bad habits.
• Obesity.

Functional (follicular)

According to statistics, the most common type of cyst is functional, or corpus luteum. It occurs quite often in women of reproductive age. Every month healthy woman A follicle matures on one of the ovaries. It contains the egg. If fertilization does not occur, an underdeveloped unfertilized egg is released from the follicle, and the woman begins her period. However, this process does not always go so smoothly. The slightest disruption in the body can prevent the follicle from rupturing. In this case, it fills with liquid. The walls of such a bubble are thin. The larger it is, the thinner they are. But you shouldn’t worry: usually by the next time your period comes, it will completely resolve. If this does not happen, it begins to fill with liquid and increase. If a diagnosis of follicular ovarian cyst has been made, the size for surgery is usually 8 centimeters. Only in rare cases is it found larger than this limit.

However, it does not come to surgical intervention so often. With a properly structured conservative treatment regimen, it will go away on its own. The most important thing that is required of a woman is to consult a doctor at the first sign. Almost always such an ovarian cyst (see photo in the article) is accompanied nagging pain in the lower abdomen, usually worsening after ovulation.

A complication that can occur if this formation is ignored is torsion of the cyst stalk, as well as its rupture.

Although often such bubbles small sizes doctors accidentally discover them on an ultrasound, and they do not pose any danger

Dermoid

This type of cyst differs from the follicular one. Although the clinical picture is very similar: the woman begins to feel pain in one of the ovaries and complains of abdominal pain. Typically, dermoid cysts are not large. As a rule, it begins to manifest itself, reaching 3-5 centimeters. During the examination, the doctor will feel a lump on one of the ovaries. The walls of such a bubble are quite dense, but elastic. prescribed by a doctor, will be able to determine that it is a dermoid ovarian cyst. The symptoms and treatment of a woman with such an education differ from the functional one. It does not go away on its own and usually requires surgery.

As a result, a bubble forms in the body from connective tissue. It is usually observed in girls during adolescence, women experiencing menopause, and also in pregnant women. A sharp increase in hubbub provokes the development of such a cyst. In rare cases, when treatment was not carried out on time, the so-called teratoma can increase up to twelve centimeters in size and even develop into a malignant tumor.

A characteristic feature of this type of cyst is its gel-like contents. When removing such a tumor, doctors find the rudiments of teeth in the cavity of the bladder, hair follicles, cartilage. What is noteworthy: in the cavity of this tumor there are developed sebaceous glands. Therefore, it also contains adipose tissue.

The smaller the formation, the easier it is to remove. If you were told during an ultrasound that you have a teratoma, you should not be alarmed. In most cases, this is a benign ovarian cyst. The size for the operation is not important here: when diagnosing a dermoid cyst, they take necessary tests, exclude cancer formation, and then prepare the patient for surgery. Afterwards, the contents of the tumor are removed for study.

Dimensions of endometrioid ovarian cyst for surgery

Nowadays, quite often women are diagnosed with endometriosis. Under this name lies quite serious illness. It is accompanied by inflammation of the uterine mucosa. Against the background of this disease, a complication such as an endometriotic cyst may develop.

Unfortunately, doctors still cannot come to a consensus on why it forms. According to one version, this happens because during menstruation, blood from the uterine cavity enters the ovary along with endometrial cells. There they grow, forming this same cyst. Another option for its origin: during some surgical intervention, the woman’s uterus and ovaries were injured, which contributed to the development of such a cyst.

This formation manifests itself with the following symptoms:

• Lower abdominal pain.
• Difficulty conceiving.
• Too long periods (more than 10 days).
• Intestinal problems, frequent constipation.
• Increased body temperature.

Usually the scariest sign for a woman is that she is trying to get pregnant. for a long time cannot succeed. At ultrasound diagnostics An endometriotic cyst may be diagnosed.

Fortunately, there is a chance that you can do without surgery. The doctor will try first conservative treatment. Menopause is artificially created for a woman so that all reproductive organs are, so to speak, inoperative. When taking strong hormonal drugs, such tumors decrease in size or disappear completely.

However, in the case where such an ovarian cyst is large, surgery is inevitable. A formation with a diameter of more than 5 centimeters becomes dangerous to a woman’s health. If replacement therapy Hormones did not help, surgery is not possible.

IN good clinics The safest operation of all is performed - laparoscopy of an ovarian cyst. With just a few holes in the abdomen, doctors remove the tumor. After this procedure, women recover much faster than after abdominal surgery.

Paraovarian

It is believed that doctors most often diagnose a left ovarian cyst. The dimensions for the operation of such formations depend on each specific type. For example, a paraovarian tumor is characterized by the fact that it usually forms on the left side.

Such a cyst is a fused ovary and its appendage. It is located in the ligaments of the uterus. The reasons for its formation are considered endocrine diseases, untimely puberty, as well as frequent surgical abortions.

Increasing in size, such a cyst begins to put pressure on bladder and intestines. As a result, women experience frequent urge to urination and constipation. In addition, the menstrual cycle is disrupted, and sexual life becomes impossible due to constant pressing pain.

This type of cyst is considered the largest. If left untreated, the growth can reach more than ten centimeters in diameter. There are cases when paraovarian formation increased to several kilograms. This happens extremely rarely; it is usually discovered when it is very small.

Undoubtedly, if the doctor says that you have a large paraovarian cyst of the left ovary, the operation will be performed as soon as possible. Often it is not allowed to grow more than 7-8 centimeters. There are cases when such a growth is found on the right. This makes absolutely no difference to its treatment or removal.

The walls of this cyst are very dense and equipped with blood vessels.

Representatives of the fair sex will be pleased with the fact that this formation does not turn into malignant. But this does not give a woman the right to forget about him! Only timely treatment will help get rid of such a cyst. As a rule, if she small size and no longer grows, then such a growth will not cause any harm. In this case, it is necessary to constantly monitor it using ultrasound and consultation with a gynecologist.

Unfortunately, it does not resolve on its own. In rare complicated cases, the doctor will perform abdominal surgery to remove it. A small diameter ovarian cyst is removed using laparoscopy.

Cystadenoma

This is another type of cystic tumor. It has clear contours and is filled. It can consist of one or more chambers.

If you have ovarian cancer, the size for surgery for such a tumor is more than 5 centimeters in diameter. Cases have been recorded when it grew to more than 30 cm. This is clearly an advanced disease that gave the woman unbearable pain. However, for some reason, such patients did not turn to doctors for help in time. With this complication, there is a noticeable enlargement of one part of the abdomen, precisely the one where the tumor is localized.

In rare cases, it can develop into malignant.

At the first signs of such a cyst, the doctor prescribes anti-inflammatory and antitumor medications, hormone therapy and strengthening with vitamins. Often conservative treatment gives good results.

Complications

In some cases, ovarian cysts can lead to some complications. Usually they are as follows:

• Cyst rupture. In this case, the entire contents of the bladder enter the abdominal cavity. In this case, a process similar to a ruptured appendix occurs - peritonitis. Woman feels sharp pain, her body temperature rises, and loss of consciousness may occur. All this is fraught internal bleeding. The patient must be urgently taken to a medical facility.
• Twisting of the cyst. In this case, the ovary is “hostage”. Blood does not flow to it, and therefore develops quickly pain syndrome, which cannot be stopped with any medications. If torsion occurs, the ovarian cyst will be removed immediately. Unfortunately, sometimes along with him. If the ovary has no blood supply long time, then its tissues die, which cannot be restored.
• Go to malignancy. This usually happens when the cyst has been ignored for a long time. If treatment is not started on time, it can contribute to tissue degeneration, and this is already very, very dangerous. Therefore, you should immediately consult a doctor if you suspect that you have an ovarian cyst. The size for surgery of such tumors is determined by the doctor. It happened that the follicular cyst reached more than 8 cm in diameter, but went away on its own, without the intervention of a surgeon. Everything is very individual.
• Inflammation. Long-term development cysts can cause suppuration on the ovary. In this case, antibacterial therapy should be prescribed immediately.

Surgery to remove an ovarian cyst

Modern medicine can easily cope with this disease. When it doesn't help conservative therapy, doctors perform an operation. In the minds of many women, a picture immediately appears: a surgeon with a mask on his face cuts her stomach lengthwise and crosswise. Just a couple of decades ago this was the case. But now there are more gentle methods. For example, laparoscopy. The doctor uses a special instrument to make small holes in the abdomen. Then surgery is performed to remove the cyst. First, its contents are carefully removed, which are subsequently sent for histology. Afterwards the walls of the bubble are removed. The easiest way is to remove functional cysts. They are practically safe and have thin walls.

A dermoid cyst requires more thorough intervention, since its cavity contains various solid elements.

In cases where there is a sudden rupture of the cyst or its torsion, the operation is performed urgently. In this situation, it will most likely be cavitary. Rehabilitation after it is about ten days. With laparoscopy, this period is reduced by three times.

An ovarian cyst may appear again after surgery. However, many women, knowing the reasons for its formation, try to warn themselves against this in the future.

First, you need to carefully monitor the schedule for taking prescribed medications. If you don't do this, a relapse won't keep you waiting. But is it worth the pain that you had to go through during the operation? Secondly, if an ovarian cyst is removed, this does not threaten your reproductive function at all. Having recovered, a woman can become a mother again.

Usually, surgical intervention ends successfully; there is no need to be afraid of it or delay it. Otherwise, there is a risk of complications.

After the operation will continue painful sensations which will pass in a few days. Taking medications will ease your condition. And don’t forget about sexual rest, which the doctor will prescribe for you. Subject to these simple recommendations the process will be much easier.

Conclusion

From our article you learned at what size of ovarian cyst surgery is performed. However, it does not always matter. First you need to find out the reason why it formed. Then the doctor will determine her type by prescribing the woman the necessary tests and ultrasound examination. As a rule, it becomes necessary to determine the level of special hormones, the number of leukocytes in the blood, and the determination of tumor markers.

After all these procedures, it is decided how the treatment will be carried out. Large cysts (from 8 centimeters) are almost always removed promptly. Most often this occurs using laparoscopy.

Follicular cysts tend to disappear on their own. However, if they appear regularly, hormonal therapy should be prescribed to avoid their occurrence in the future. True, as experts note, such cysts will appear and disappear on their own almost throughout the entire fertile period of a woman’s life.

An endometriotic cyst requires more complex treatment. Even after its removal, it is necessary to carefully treat the uterine mucosa, which will help eliminate relapses.

Other types of cysts appear only once and, once removed, never return.

Content

In most cases, ovarian cysts occur in women of reproductive age, but are sometimes observed in the postmenopausal period. This is a benign formation containing fluid inside. The cause of the pathology is a hormonal imbalance, when the process of releasing an unfertilized egg from the body occurs incorrectly.

When is surgery necessary to remove an ovarian cyst?

Surgery for an ovarian cyst is recommended if it is constantly growing and does not disappear after several menstrual cycles. IN mandatory removal is prescribed at the slightest suspicion of cancer. Ovarian resection does not always mean cutting off the organ completely. In most cases, a cystectomy of the ovarian cyst is performed - a surgical intervention in which healthy tissue is preserved as much as possible.

Sometimes it is necessary to remove the cyst along with the ovary. In this case, oophorectomy is prescribed - the most inexpensive one. The second ovary remains intact and fully functioning. When there is a risk of conversion benign tumor malignant, a hysterectomy is required. During this operation, both ovaries are excised along with the fallopian tube or uterus. Access to the abdominal cavity is achieved either through surgical incisions or laparoscopic punctures. Removal of an ovarian cyst is required if:

• suspicion of cancer;
• there is constant pain;
• polycystic disease;
• no signs of regression;
• internal bleeding due to cyst rupture;
• an overgrown tumor disrupts blood flow to the organ;
• the cyst puts pressure on other organs.

Laparoscopy

The simplest and easiest operation today is ovarian laparoscopy. Its essence lies in the fact that 3 small punctures are created in the lower abdominal cavity, through which a video camera and surgeon’s instruments are inserted. In the modern medical world, laparoscopy is considered the most painless, because abdominal surgery is accompanied by tissue trauma, to which the body reacts very sharply.

The advantage of this intervention is that the surgeon, using a video camera equipped with powerful lenses, sees everything very clearly, which increases the accuracy of the work. Laparoscopy is performed under local or general anesthesia, so the woman does not feel anything. First, it is fed into the abdominal cavity carbon dioxide, so that it straightens and the organs are better visible. Then the surgeon removes the formation without damaging healthy tissue, and at the end, after releasing the gas, cosmetic sutures and bandages are applied to the incisions.

Laser

The operation to remove a cystic ovarian formation with a laser is even faster and more accurate than with laparoscopy. These two methods are very similar, only the resection instrument is not a surgeon’s scalpel, but a laser beam. With this method of excision of an ovarian cyst, the likelihood of bleeding is minimized, since the laser simultaneously cauterizes the blood at the site of excision of the tumor.

Laparotomy

In this surgical procedure, incisions are made in the woman's abdomen through which the surgeon removes the cyst or ovary, depending on the indication. Laparotomy is considered to be an abdominal operation, and it is prescribed in the following cases:

• purulent processes;
• large cyst;
• rupture or torsion;
• adhesions;
• oncological formations.

Preparation for the operation

If a woman is scheduled to have an ovarian cyst removed, then she needs to undergo a series of tests: urine and blood: general, biochemical, group and Rh factor. Also required laboratory research on infectious diseases. A week before the appointment surgical intervention You should follow a special diet, in which you are prohibited from eating fatty meat, brown bread, baked flour products, raw vegetables and fruits, carbonated drinks, in general, those foods that increase gas formation in the intestines.

Immediately before laparoscopy, you need to empty your stomach; to do this, you need to stop eating any foods at least 10 hours before the operation. Last time You can eat at 18:00 and drink until 22:00. The night before, you need to take laxatives and use an enema. In the morning, you need to repeat the procedure for cleansing the intestines using an enema.

How to remove an ovarian cyst with a laparoscope

Removing a cyst using laparoscopy allows you to reduce the burden on the body using regional anesthesia and minimize the consequences of surgery. The operation is performed under epidural anesthesia, but if there is an increased risk of bleeding, they may prescribe general anesthesia. The process begins with a puncture and insertion into bottom part belly 3000 cm3 of nitrous oxide or carbon monoxide. Afterwards, two or three more incisions are made into which the laparoscope and surgical instruments are inserted.

The doctor evaluates the condition of the affected ovary and other pelvic organs. A large tumor is removed in two stages: first, the capsule is punctured, after which its contents are aspirated, and only then it is removed. With this approach, it is easy to avoid rupture of the cyst during its excision. The extracted material is sent for histological examination to exclude oncology. Finally, the surgeon rinses the abdominal cavity, installs a drainage tube, and then places single sutures on the puncture sites.

Recovery after laparoscopy

Patient in postoperative period may feel nervous discomfort associated with unreasonable fears. The doctor prescribes antibiotics and painkillers to avoid inflammation. If the discharge and elevated temperature do not go away in the first hours after the intervention, then an additional examination is carried out. Sutures are removed one week after laparoscopy. If all recommendations are followed, recovery takes place without consequences, and after 2-3 weeks the ability to work is fully restored.

How is abdominal surgery to remove an ovarian cyst performed?

Open abdominal surgery is performed by layer-by-layer dissection of the anterior abdominal wall. After this, the cystic formation is removed, and adhesions are dissected if necessary. If the cyst is endometrioid, then the vesicouterine fold, omentum, intestines and peritoneum are visible for the presence of foci. After the operation, the layers of the abdominal wall are sutured in the reverse order.

Rehabilitation after laparotomy

The patient stays in the hospital for 4-5 days, and fully returns to active life after 1-1.5 months. For women who are planning a pregnancy, doctors try to preserve the uterus and ovaries so that they can become pregnant later. During menopause, the patient has two ovaries removed so that there are no unnecessary consequences, and the woman can safely continue to be sexually active. Possible complications after laparotomy:

• infectious processes;
• damage to internal organs;
• pain syndrome;
• formation of adhesions.

How long does the operation take?

Laparoscopy is performed, depending on the experience of the surgeon and the type of intervention, from 20 minutes to 1.5 hours. With laparotomy, the duration of the operation can be up to 2 hours. If there is a suspicion of a malignant cystic formation, then removal of the fallopian tube is included, so the doctor may need more time. The surgeon selects the surgical tactics individually each time.

Is it necessary to remove a cyst during pregnancy?

There are many cases where a woman becomes pregnant but develops a dermoid cyst. First, a wait-and-see approach is carried out - the gynecologist monitors the tumor via ultrasound. If traditional treatment does not help, then an urgent operation will be prescribed at any time. How is an ovarian cyst removed during pregnancy? Laparoscopy is mainly used. But if the cyst reaches a large size, then the patient will have to undergo a laparotomy, at which the cost may be too high, since there are risks for both the mother and the child.

Price

The cost of laparoscopy is not calculated by just one operation. It will not be possible to remove a cyst inexpensively, since the prices for laboratory tests and hospital stay must be taken into account. The anesthesia used, additional tests and care taken are considered separately. rehabilitation period. average price for laparoscopy in a state institution varies from 15 to 45 thousand rubles. Abdominal surgery will be more expensive. The price for laparotomy starts from 25 thousand rubles.

Video

It occurs due to an increase in the amount of secretion in the cavity, and in this way it is fundamentally different from a tumor, which grows due to atypical division of cellular structures.

The cyst often remains asymptomatic for a long time, and a woman finds out about its presence by chance during a routine examination.

However, in some cases cystic neoplasm becomes complicated - occurs or, which leads to bright clinical picture and to the need urgent intervention surgeon

The essence of pathology

Cystic neoplasms are classified into two large groups– cysts and organic cysts.

• clinical blood and urine tests;
• blood chemistry;
• analysis to determine blood group;
• blood test for infections;
• vaginal smear;
• fluorography;
• coagulogram;

If necessary, the list of tests can be expanded:

• cervical smear cytology;
• Doppler ultrasound of veins (for thrombosis, varicose veins, and also after 50 years);
• conclusions from specialized specialists (if there are serious chronic diseases).

How to prepare?

Your attending physician will tell you in detail how to prepare for surgery.

TO elective surgery preparation begins several months in advance.

First of all, you need to decide on the clinic where the procedure will be carried out. surgical intervention, find out prices, and choose a qualified doctor.

When the date of the operation is set, the following rules must be followed::

• adhere to dietary nutrition;
• start taking it one week before surgery Activated carbon, the dosage will be prescribed by the doctor;
• for 4 days try to eat only liquid food;
• remove on the eve of the procedure hairline in the pubic area;
• in the evening before the operation, do a cleansing enema;
• after dinner on the eve of the operation, drink only water and eat nothing else;
• The doctor will also prescribe antipsychotic medications.

How is the procedure performed?

The procedure for laparoscopy and laparotomy is of course different.

Laparoscopy:

• The patient is given anesthesia.
• The surgeon makes 3 or 4 incisions in the peritoneum. The size of the incisions is no more than 1.5 cm. Next, the muscles and tissues are carefully pulled apart.
• A probe, a camera equipped with a flashlight, and all the necessary instruments that will be required during the intervention are inserted.
• Gas is pumped into the abdominal cavity, which is necessary to raise the abdominal wall and separate the organs from each other.
• The camera displays the image on the screen, and the doctor begins to remove the cyst.
• After all the necessary manipulations, all tubes and instruments are removed, and the incisions are sutured.

Laparoscopy lasts from 20 minutes to 1.5 hours. The time of intervention depends on the stage of the pathology and its location.

Laparotomy is performed under general anesthesia, and includes the following steps:

• the area of ​​skin where the incision will be made is treated with an antiseptic;
• a horizontal incision is made in the lower abdomen;
• the neoplasm is removed by excision, if necessary, damaged tissue is excised;
• the vessels are ligated or cauterized with electric current;
• the incision is sutured.

Possible complications

Abdominal surgery to remove a cyst along with the ovary is a serious and complex operation, which can lead to the following consequences:

1. Adhesive process.
2. Hormonal disbalance. If only one ovary is removed, the body will be able to compensate for the lack of hormones, which means the woman has the opportunity to realize reproductive function. If both ovaries are removed, the woman becomes infertile and will also need hormone replacement therapy.
3. Early onset of menopause.
4. Disruption of metabolic processes, development of atherosclerosis.
5. Obesity.
6. Sexual dysfunction.

Recovery period

After laparoscopy, the recovery period lasts about 2 weeks. The total rehabilitation period is one month.

To make this period pass faster and not be accompanied by complications, the following measures are necessary::

• taking hormonal medications prescribed by a doctor;
• photophoresis;
• laser or magnet therapy;
• correct;
• moderate loads;
• physiotherapeutic treatment.

After laparotomy, the recovery period will, of course, take longer.

Sexual contacts after surgery are allowed only 4 weeks after the intervention.

If the temperature rises, pain in the lower abdomen and nausea appear, you should immediately consult a doctor, as this may be a sign of an inflammatory process.

Consequences of cyst removal

After removal of a cystic formation, the following consequences may be observed::

• pain symptom that can last up to 10 days;
• increased gas formation;
• bloating;
• constipation;
• flatulence;
• adhesive process;
• infection;
• development of endometriosis;
• hormonal disorders;
• relapse of pathology.

NOTE!

Most of the consequences are not dangerous and disappear within recovery period, but if serious complications occur, consultation with a doctor and treatment are necessary.

An ovarian cyst is benign education non-tumoral nature requiring surgical treatment. Most effective method surgical intervention in this case will be laparoscopy - a delicate operation accompanied by minimal trauma to the abdominal cavity and allowing it not to affect the functionality of the ovary.

Laparoscopy is used to treat follicular neoplasms of the corpus luteum. In the vast majority of cases, doctors manage to preserve the organ and not affect its functionality: after removing the cyst, women retain the ability to conceive and bear a fetus.

Indications

One of the most common diseases of modern gynecology - endometrioid ovarian cyst (a hollow formation measuring from 1.5 to 10 cm, inside of which there is old coagulated brown blood) - requires medical diagnostics And surgical treatment. Accordingly, than formerly a woman turn to a specialist, the less damage to the body, in particular, reproductive function, will be caused.

Women with a genetic predisposition to follicular formations should undergo a routine examination by a specialist. The cyst begins its development when menstrual blood enters the pelvic cavity through the tubes: cells of the inner surface of the uterus (endometrium) attach to various bodies, including the ovaries, where they develop under the influence of progesterone and estrogen, causing regular inflammatory processes. Biochemical processes that occur during inflammation often lead to infertility.

An examination may be necessary if you have the following symptoms:

• pelvic pain before and during menstruation;
• significant discomfort during sexual intercourse;
• pain when urinating.

Since the disease is often asymptomatic, and the cyst may not bother you for many years, it will help to eliminate the risk of its development routine inspection from a gynecologist.

In most cases, an ovarian cyst is removed routinely, but endometrioid and other formations are corpus luteum have a risk of rupture of the cyst capsule or malnutrition. If such factors are present, surgery is prescribed in urgently and may be accompanied by removal of the appendage (tube and ovary on the affected side).

List of diseases

Removal of an ovarian cyst is effective in combating the following diseases:

• formation in the ovary (follicular, tumor), which cannot be regressed within three months (on its own or under the influence of hormonal agents);
• formations that appeared during menopause;
• “twisted” cyst pedicle; rupture of the follicle, suppuration, hemorrhage;
• suspicion of malignant formation in ovarian tissue.

Preparation

Before an operation to remove an ovarian cyst is scheduled, the gynecologist conducts a diagnosis, which includes the following steps:

• taking anamnesis;
• manual examination;
• Ultrasound of the pelvic organs, performed in at least two menstrual cycles;
• colposcopy;
• fluorography;
• flora research;
• blood tests - biochemical, clinical, histological (ROMA index, CA-125), to determine the Rh factor, blood type and coagulability, for HIV and RW;
• MRI of the pelvic organs (may be required for a more accurate diagnosis).

One of the contraindications to laparoscopy may be overweight, therefore, before the operation, the doctor may prescribe a special diet and set of exercises to normalize body weight.

Immediately before the operation, you need to take a bath and remove hair from the abdomen and external genitalia. The last meal is until 19:00, drinking is at 22:00. Before the operation, it is necessary to cleanse the intestines with an enema - this will greatly simplify the surgical procedure and increase the range of action of laparoscopy instruments and the viewing radius.

How does the procedure work?

• diagnostic laparoscopy (to confirm the diagnosis);
• therapeutic laparoscopy (to eliminate the cyst);
• control laparoscopy (to check the condition of the organ after treatment).

Laparoscopy of a cyst with preservation of the ovary:

• the operation is performed under general anesthesia;
• for greater convenience, carbon dioxide is injected into the abdominal cavity, which raises the wall in such a way as to give the doctor maximum visibility of the organs;
• during laparoscopy, small incisions are made on the skin of the abdomen (anterior abdominal wall), no more than 1.5 cm in size (up to 4 incisions);
• through them, trocars are inserted into the walls of the cavity to install the camera and instruments;
• the cyst follicle is isolated within healthy tissues, performing thorough hemostasis of the formation bed, then several internal sutures subject to resorption are applied to the cyst site;
• the cyst is placed in a plastic container and removed through one of the incisions, then transferred for histological examination to the laboratory.

Ovarian resection

If a tumor, polycystic disease or cancer is found on the ovary, ovarian resection is prescribed. Surgery is prescribed only as a last resort, and doctors often try to use minimally invasive methods to treat ovarian cysts.

Postoperative period

On the first day after surgery, the doctor prescribes painkillers. If necessary, the doctor may prescribe an additional course of antibiotics. You are allowed to get out of bed 3-5 hours after laparoscopy. Discharge from the hospital occurs within two days in the absence of complications. Suture removal is scheduled 6-7 days after surgery. Before the start of the next menstruation, a woman is not recommended to lift heavy objects, experience significant physical activity, or engage in sex life. The scars from the operation disappear in a short time and become invisible. During the first 24 hours after recovery from anesthesia, patients may experience pain, which is relieved with anesthetics.

Nutrition

After laparoscopy, the doctor may prescribe a special diet that excludes alcoholic drinks and heavy food. In the first days after surgery, experts recommend consuming broths, fermented milk products, cereals, up to 1.5 liters of water per day and sticking to fractional meals(eat food in small portions, dividing it into 5-6 meals).

Possible complications

The following symptoms may indicate the presence of infection:

• increased body temperature;
• lower abdominal pain;
• dark colored discharge.

Most often, complications occur due to factors:

• obesity;
• taking certain types of medications;
• alcohol and tobacco consumption;
• pregnancy.

At the first symptoms of discomfort after surgery, you must immediately consult a doctor for an ultrasound and detailed diagnostics, based on the results of which re-treatment will be prescribed.

Pregnancy after laparoscopy

Many women worry about the possibility of pregnancy after laparoscopy. Modern technologies minimally invasive surgical treatment allow you to maintain reproductive ability even after removal of a formation of significant size.

A woman should plan to conceive no earlier than 2-6 months after the operation. Regular visits to your doctor to monitor your condition are also required. Observation in a hospital for a detailed examination is possible. To maintain health and prevent the recurrence of formations in the ovary, your doctor may prescribe drug treatment, directed balancing of hormonal levels.

In the postoperative period, pregnancy may not occur due to the persistence of the disease focus. In this situation, a repeat laparoscopy is prescribed to finally remove the cyst and complete the treatment.