Is it necessary to remove an ovarian cyst: treatment or surgery? How an ovarian cyst is removed: a review of effective methods and reviews from women. How an ovarian cyst is removed.

05.11.2019 -

First of all - tests

The doctor will carry out the complex diagnostic studies, which will provide all the necessary information about the patient’s condition. In particular, it is necessary to do a urine and blood test (including biochemistry and blood clotting), fluorography and an electrocardiogram.

Studying the results

The results of the research will be carefully studied by both the surgeon and the anesthesiologist, who will do everything necessary to ensure that you remain under anesthesia (and the operation is performed under general anesthesia) passed without consequences for the patient and did not last longer than the time required for the surgeon’s manipulations.

Moral preparation

The surgeon will tell the patient about the features of the upcoming operation, and the anesthesiologist will tell the patient about the state of artificial “sleep” into which the woman will be immersed. Our doctors are not only competent specialists, but also excellent psychologists who know how to calm even the most anxious patient.

What about food?

Sister, scalpel! Let's start laparoscopy

In fact, no scalpel is needed, and here's why.

Medicine of the 21st century: “massacre” is a thing of the past

Until recently, surgery to remove a cyst was performed only using the traditional abdominal method (called laparotomy). It involves making a large incision through which the cyst is removed, and the recovery period can be long and painful.

But Best Clinic specialists have been successfully practicing modern technology for several years now. endoscopic method- laparoscopy. With this method, three tiny punctures are made on the abdominal wall, into which miniature instruments are inserted.

You are in the operating room. What do doctors do?

First, the anesthesiologist comes into play with his assistant - the Fabius Tiro apparatus. The patient gradually falls into a medicated sleep, and the anesthesiologist closely monitors her condition throughout the operation.

The surgeon then inserts abdominal cavity sick special gas, which expands the “field of activity” of the doctor and allows him to see the cyst in detail.

A laparoscope, a probe with a miniature video camera, is inserted into the puncture of the abdominal wall. These are the “eyes” of the surgeon. The image from the video camera is transmitted to the screen.

The doctor will take a small part of the cystic tissue for analysis (it is necessary to exclude malignancy of the neoplasm), and then begin removal.

Plasma comes into play

The Best Clinic uses the innovative plasma system PLASMAJET to remove cysts and other tumors. It is a significant leap forward compared to the more familiar laser and electrocoagulation methods of cyst removal (there is not even a question of “classical” scalpels, as we said).

The plasma flow evaporates the cyst tissue without affecting the surrounding organs. This gentle method of exposure allows us to eliminate such unpleasant consequences of removing tumors using “traditional” methods as adhesions in the pelvis.

Just a little left: completion of the operation

After the ovarian cyst is dealt with, the surgeon, using the LigaSure device, “seals” the damaged vessels. Thus, there will be no even minimal bleeding. All that remains for the doctor now is to close the punctures into which the instruments were inserted with a few stitches.

The total duration of the operation is about half an hour, after which the patient is transported to another room, and the resuscitator begins to awaken her.

Recovering after cyst removal

The rehabilitation process will not take much time. Within a few hours after laparoscopy, the doctor will ask the patient to stand up, and by the evening (if the intervention was performed in the morning) the woman will be able to walk. On the first day after surgery, it is necessary to take painkillers, then discomfort practically disappear.

Usually the patient is discharged from the clinic on the second or third day, and she can return to normal life. In a week, the doctor will remove the stitches. The small scars left after punctures completely disappear within six months in most of those operated on.

The doctor will continue to monitor the patient’s condition and prescribe preventative examinations for her.

Pregnancy after laparoscopy: is it possible?

Yes, this is definitely possible. Often it is the ovarian cyst that becomes an obstacle to pregnancy, and therefore after its removal the chances of becoming a mother increase significantly.

You just need to remember that experts do not recommend planning a pregnancy earlier than six months after the operation in order to exclude the possibility of miscarriage. Listen to the advice of the gynecologist who is observing you: knowing everything about your condition, he will accurately determine whether the time has come to conceive a baby.

And don't forget that cystic formations It is necessary not only to remove it in time, but also to identify it as quickly as possible. Therefore, make an appointment at Best Clinic and rest assured that you are in good hands.

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 benign education, which 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 reveal whether there is a risk cancerous tumor.

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.
Violation menstrual cycle. 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 an 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, before surgical intervention it doesn't happen that 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. After this, 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, surgical intervention is impossible.

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 such a 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 sex 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, hormonal therapy and vitamin supplementation. 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 simplest method 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.

I decided to undergo an abdominal ultrasound. The reason was my disgusting condition for 4 months. In the evening, after eating, I felt bad, a heaviness appeared in my stomach, and I began to choke. Severe heartburn and stomach pain happened to me almost every month. The doctors treated my stomach, but I only got worse. An ultrasound showed that my stomach was healthy. Then the doctor suggested checking the pelvis. And then a pelvic ultrasound revealed a left ovarian cyst, which was so large that it was compressing all neighboring organs.

I urgently went to a gynecologist, who confirmed my diagnosis and advised me to remove the cyst as quickly as possible.

At first I was in a little shock, the operation, and I had never been in the hospital before. Then I started looking for information on the Internet. Is it possible to somehow cure a cyst with pills? The gynecologist, of course, explained to me what this large cyst ovary, you just need to operate, but my brain refused to believe it.

Resigned, I began to think about which hospital would be better to undergo surgery. The ultrasound doctor advised me to go to the Russian Railways hospital, which I did. Manager gynecological department She listened to me, looked at me and we set an approximate date for the operation - laparoscopy.

Laparoscopy.

The doctor makes small incisions through which he inserts special micro-instruments. The location of the incisions depends on the organ being operated on. For example, to remove a cyst, they are performed in the lower abdomen. The next step is to inflate the patient’s abdomen with gas to allow the instruments to move freely in the peritoneum. The patient’s preparation is now complete, and the doctor begins the operation. In addition to the small incisions, the doctor makes one slightly larger incision through which the video camera will be inserted. Most often it is done in the navel area (above or below). Once the camera is properly connected and all instruments are inserted, an enlarged image is displayed on the screen. The surgeon, focusing on it, carries out the necessary actions in the patient’s body. It is difficult to immediately say how long such an operation lasts. The duration can vary from 10 minutes to an hour.
After surgery in mandatory install drainage. This is a necessary procedure after laparoscopy, which is designed to remove bloody postoperative residues, the contents of ulcers and wounds from the peritoneum to the outside. Installation of drainage helps prevent possible peritonitis.
The operation is performed under general anesthesia. Before administering a sleeping pill, the anesthesiologist takes into account age characteristics, height, weight and gender of the patient. After the anesthesia has taken effect, so that various sudden situations do not occur, the patient is connected to an artificial respiration device.

I was given a list of tests that needed to be prepared for the operation.

The list turned out to be quite large, everything that I circled had to be completed. Points 1 to 8 took place at the district antenatal clinic. Points 12 and 14 I was also given a referral to the antenatal clinic. A referral for FGS was given to me by a local therapist, and also based on all collected analyzes The therapist wrote a conclusion and permission for the operation.

I already had a pelvic ultrasound and histology. All that remained was to visit a vascular surgeon, who saw me in another hospital and the appointment with him cost me 750 rubles. The surgeon looked at my legs and said that everything was fine, but for the operation I needed to buy medical compression stockings, which needed to be put on before the operation to avoid the formation of venous thrombosis and pulmonary embolism.

All tests must be no later than 10 days ago, points 5 and 8 - 3 months.

Having collected all the tests and the report, which is written by the gynecologist and signed by the therapist, I called the manager and she finally set the date for the operation - Tuesday.

On Monday morning, I packed my things and arrived at the hospital. I paid for a room for a week, it cost me 4,800 rubles. The room was double, with a toilet and a refrigerator. I had lunch at the hospital, but I was forbidden to have dinner. Before going to bed I was given an enema and a sedative injection.

The next day, at 7 am, they woke me up and told me to put on medical compression stockings without getting out of bed. I was not allowed to have breakfast or drink and was again taken for an enema. At around 10 am they began to prepare me for the operation. They invited me into a small operating room, where they inserted urinary catheter. And I’ll tell you this, it was the most unpleasant of all the procedures that were performed on me, my thought at that moment was to get up and leave and I didn’t give a damn about all sorts of operations. But gathering all my will into a fist, after all, so much has already been done, all that’s left is just a little patience and you’re healthy, I pulled myself together. They put me on a gurney and took me to the operating room.

In the operating room they put a cap on me, inserted an IV system into my arm, and put a cuff on my other arm that measured the pressure. Treated stomach alcohol solution. They connected the oxygen mask and began to administer anesthesia. After a couple of minutes I passed out. Under general anesthesia I had some dreams that I don’t remember.

I woke up from a sharp jolt in my stomach. I was taken to the intensive care ward, where everyone is placed for a day after surgery. They began to warm me up and bring me to my senses. It was a little difficult to breathe, mucus accumulated in my throat, but after I drank, everything went away. An hour later, I was already drinking, but I couldn’t eat. I was constantly given IVs and given injections a couple of times. They brought me a phone to the intensive care unit, I was able to call my husband and parents and calm everyone down.

In bed, I began to move a little, but it was still difficult to turn over. Many people write that after laparoscopy their ribs and shoulders hurt from the air that is introduced during the operation, but I didn’t have any pain at all, I was warm and calm. Periodically, I fell asleep and woke up again; I can only sleep soundly at home.

The next morning I was transferred to a ward, the urinary catheter was removed, the stitches were cleaned and an IV was placed. On the left, at the site of the incision, I had a drain from which pinkish water gradually flowed. It’s not scary, but it’s a little inconvenient; the nightgown constantly gets dirty.

Little by little I began to get up, made my way to the toilet, which fortunately was in the room, and even managed to wash my hair in the sink. I was alone in the ward; my neighbor, with whom I spent the first day in the hospital, was discharged while I was in intensive care.

I was fed special postoperative food for another day: liquid porridge, meat broth, and then I was allowed to eat normally. But to be honest, I didn’t have much of an appetite, although the food at the hospital was very tasty and filling, and I also had yoghurts and bananas in the refrigerator.

I had the operation on Tuesday, and on Friday my drainage was removed. The incision sites were sealed with special sterile adhesives; they did not hurt at all, but it was still difficult for me to walk.

On Saturday morning I was allowed to go home for the weekend, and on Monday morning I arrived at the hospital to get tests and stitches removed. After the stitches were removed, they gave me a statement, which indicated what and how was carried out during the treatment.

They prescribed me a dose of Vizzana, which I drank exactly one package; I didn’t have enough for more.

Two weeks later I arrived for histological examination removed cyst of the left ovary.

A month after the operation I went for an ultrasound. The left ovary was small.

Half a year after the operation, my ovary remains the same small, the gynecologist gave me a conclusion: dysfunction of the left ovary. They didn’t prescribe any medications, they suggested taking Inofert dietary supplement, after taking which there was no result. I think that in principle it was possible not to drink it.

Now there are a lot of women diagnosed with an ovarian cyst, or even two, my gynecologist, with whom I am now seeing, told me about this. To my question, where does this sore come from for so many people, she answers ecology and products.

My operation was easy, although with such a large ovarian cyst, the doctors in the operating room were ready for anything.

I hope my review will be useful to those who, like me, have been diagnosed with an ovarian cyst. After all, the first thing I did was look for reviews, because I was scared and didn’t know what was in store for me. I didn’t take any photographs of the places of incisions and scars on purpose now, so as not to frighten the particularly impressionable.

I wish everyone health and good doctor, and if you don’t trust one doctor, visit several more. After all, it’s always a good idea to double-check the diagnosis, especially when it comes to women’s health.

14 months have passed since the operation and I decided to update my review.

Exactly one year later, the function of the left, appended, ovary returned to normal. From medicines over the past month I have only taken Cyclavita vitamins, which my gynecologist recommended to me. After the receptions, I had a double impression. Rather, I drank them like this for prevention. I didn’t see any benefit from them, but I gained fat.

In general, as I assume, the ovary began to function normally on its own a year after the operation, you just had to wait. Neither Inofert nor Cyclovita had any influence on his work, either for the worse or for the better.

Ovarian cysts are a common cause of lower abdominal pain and infertility. They are of different origins and structure, but a cyst of any type at a certain stage of its development may require surgical treatment. Modern gentle surgical method is laparoscopy of an ovarian cyst, which allows to reduce the length of hospitalization and speed up post-operative recovery patients.

What is an ovarian cyst

A cyst is a round, hollow formation on the surface of the ovary or in its thickness, resembling a bubble. Its contents and wall structure depend on its origin. Although she belongs to benign tumors, some types of cysts can degenerate with the appearance cancer cells. This process is called malignancy.

Sometimes a similar formation occurs in ovarian cancer, when, due to central disintegration, an uneven cavity is formed inside the tumor. During examination, women may also be diagnosed with paraovarian cysts. The fallopian tubes take part in their formation, but the ovarian tissue remains unchanged.

Possible types ovarian cysts:

, which is formed from a follicle that did not rupture during the ovulatory period, streaks of blood are sometimes found in the fluid inside such a cyst;
, arising at the site of the ovulated follicle (in corpus luteum), contains serous fluid and sometimes an admixture of blood from destroyed small vessels;
, which develops when endometrial cells multiply outside the lining of the uterus, undergoes cyclic changes in accordance with the menstrual cycle and contains a dark, thick liquid;
a dermoid cyst (or mature teratoma) may contain germinal tissue or even partially formed formations (teeth, hair), is formed at the site of an egg that has begun to develop independently and is often congenital;
mucinous - is multi-chambered and contains mucus, can grow up to 40 cm in diameter.

Follicular cysts can be multiple, in this case they speak of. Moreover, in each cycle the egg does not ovulate, the follicle continues to grow and turns into a cavity under outer shell ovary. Other types of cysts are usually solitary.

When does pathology require treatment?

Follicular and luteal cysts are hormonal-dependent and can gradually resolve. But if they reach large sizes and do not undergo reverse development, they must be removed. When endometrioid formations are detected, conservative therapy is first prescribed. If it is ineffective and there are large formations, a decision is made on surgery. All other types of cysts require only surgical treatment. In case of infertility, the doctor may recommend removing even small tumors, after which most often prescribed hormone therapy.

The purpose of the operation is complete removal pathological formation. In women of reproductive age, they try to preserve the ovarian tissue as much as possible, performing only resection. And in postmenopause, when sex hormones are practically no longer produced, the entire organ can be removed without consequences for the woman’s health.

The operation is performed using the classical method (through an incision on the anterior abdominal wall) or laparoscopic removal of the ovarian cyst is performed. In both cases, the woman goes to the hospital, most often such hospitalization is planned.

Benefits of laparoscopy

Removal of an ovarian cyst by laparoscopy is a gentle intervention. All manipulations are performed through 3 punctures of the abdominal wall. In this case, the abdominal muscles are not dissected, the thin internal serous lining of the abdominal cavity (peritoneum) is minimally injured, and there is no need to manually move it away from the surgical site internal organs.

All this determines the main advantages of the laparoscopic method over classical surgery:

lower risk of development in the future;
low probability of a postoperative hernia, which may occur due to incompetence of the dissected muscles of the anterior abdominal wall;
small volume of surgical wounds, their fast healing;
gentle effect on neighboring organs during surgery, which reduces the risk of postoperative intestinal hypotension;
fewer restrictions in postoperative period, earlier discharge from hospital;
absence of deforming postoperative scars, puncture marks can be hidden with underwear.

The laparoscopic treatment method allows a woman to quickly return to normal life, without being embarrassed about her appearance and without worrying about the possible development of long-term consequences after surgery.

Preparation

Before laparoscopic surgery to remove an ovarian cyst, a woman must undergo an examination, which is usually performed on an outpatient basis. It includes general and biochemical analysis blood, urine test, blood collection for screening for hepatitis, syphilis and HIV, ultrasound of the pelvic organs, fluorography of the lungs, determination of blood group and Rh factor, vaginal smear for purity. In some cases, it may also be necessary to do an ECG, examine the state of the blood coagulation system, determine hormonal status, and obtain a physician’s opinion on the absence of contraindications to surgical intervention. The scope of research is determined by the doctor based on the general clinical picture.

Before performing planned laparoscopy of an ovarian cyst, reliable methods of contraception are used. If you suspect pregnancy, you must inform your doctor in advance.

A few days before surgery, you need to exclude cabbage, legumes, carbonated drinks, brown bread and other foods that increase gas formation in your diet. digestive tract. If you are predisposed to flatulence, the doctor may recommend taking sorbents and carminatives; cleansing the lower intestines is often prescribed. On the eve of the intervention, the last meal should be no later than 18:00, you can drink until 10:00 pm. On the day of surgery, it is forbidden to drink or eat, extreme thirst You can rinse your mouth and wet your lips with water.

Immediately before laparoscopy, pubic and perineal hair is shaved and a hygienic shower is taken. After this, you should not apply lotions, creams or other care products to the skin of the abdomen.

How is laparoscopy performed?

Laparoscopy for removal of an ovarian cyst is performed under general anesthesia (anesthesia). On the day of surgery, the woman is consulted by a resuscitator to identify possible contraindications and make the final decision on the type of anesthesia. Most often, tracheal intubation is used, which allows you to control breathing and maintain the required depth of immersion in anesthesia. Before this, premedication is carried out, when a sedative with a hypnotic effect is administered intravenously; tranquilizers are usually used for this. Instead of such an injection, you can use mask anesthesia.

The operating table is tilted with the head end down by 30º so that the intestine moves towards the diaphragm and opens access to the ovaries. After processing the surgical field, a puncture is made in the navel, through which the abdominal cavity is filled with carbon dioxide. This allows you to increase the distance between organs and creates space for the necessary manipulations. A laparoscope, a special instrument with a camera and a light source, is inserted into the same hole. It is advanced to the pelvis, where the ovaries are located. Under the control of a video camera, 2 more punctures are made in the lateral sections of the abdomen, closer to the groin, which are necessary for introducing manipulators with instruments.

After a thorough examination of the ovaries and cysts, a decision is made to continue laparoscopy or whether wide access to the abdominal cavity is necessary (which is quite rare). IN the latter case all instruments are removed and the classic operation begins.

During laparoscopy, the doctor can perform enucleation of the cyst, wedge-shaped resection (excision) of a fragment of the ovary with a cyst, or removal of the entire ovary. The extent of surgical intervention is determined by the type of cyst and the condition of the tissues surrounding it. At the end of the operation, a check is made for the absence of bleeding, the instruments are removed, carbon dioxide is sucked off. External sutures and sterile dressings are applied to the puncture sites.

After removing the endotracheal tube, the anesthesiologist checks the patient’s breathing and her condition and gives permission to transfer to the ward. In most cases, the patient does not need to be admitted to the department intensive care, since disruption is vital important organs And massive blood loss not happening.

Postoperative period

After laparoscopy, getting out of bed early is recommended. After just a few hours at stable blood pressure It is advisable for a woman to sit down, stand up, and carefully move around the ward. A gentle diet is prescribed, including fermented milk products, vegetable stew and meat, soups, fish, without products with gas-forming properties.

Sutures are treated daily and body temperature is monitored. Discharge is made 3-5 days after surgery, but sometimes already in the evening of the first day. Sutures are removed on an outpatient basis for 7-10 days. Full recovery Incapacity for work usually occurs by the 14th day, but if the woman is in good condition, the certificate of incapacity for work can be closed earlier.

Possibility of pregnancy

Until the end of the current menstrual cycle, it is advisable to exclude intimate contacts; if this recommendation is not followed, contraception must be used. Pregnancy after laparoscopy of an ovarian cyst can occur in the next cycle. Therefore, you should definitely check with your doctor when you can stop using contraception. At functional cysts(luteal and follicular) and polycystic ovary syndrome, conception is most often allowed after the first menstruation, if the operation and recovery period passed without complications. But after removal of endometrioid cysts, a stage often follows drug treatment.

Possible complications

The most a common complication after laparoscopy of an ovarian cyst there is pain. Moreover, unpleasant sensations are noted not in the area of the operation or punctures, but in the area of the right side and right shoulder. This is due to the accumulation of carbon dioxide residues near the liver, which irritates the phrenic nerve. Muscle pain and mild swelling may also be noted. lower limbs.

In the first days after laparoscopy, subcutaneous emphysema may be observed, that is, an accumulation of gas in the upper layers of fatty tissue. This is a consequence of a violation of the surgical technique and does not pose any health hazard. Emphysema resolves on its own.

In the long-term postoperative period, it rarely develops adhesive disease, although the risk of its occurrence after laparoscopy is significantly lower than after classical surgery.

When laparoscopy is not performed

Despite the woman's wishes, the doctor may refuse to perform laparoscopic surgery in following cases:

severe obesity (grade 3-4);
detection of stroke or myocardial infarction, decompensation of existing chronic diseases;
pronounced violations hemostasis in case of blood coagulation pathology;
abdominal surgery less than 6 months ago;
suspicion of a malignant tumor (cyst) of the ovary;
diffuse peritonitis or severe hematoperitoneum (accumulation of blood and abdominal cavity);
state of shock women, increasing severe blood loss;
pronounced changes in the anterior abdominal wall with fistulas or purulent skin lesions.

Removal of an ovarian cyst laparoscopically is a modern and gentle method of surgical intervention. But the operation should take place after a preliminary thorough examination of the woman in the absence of contraindications to it. It must be remembered that some cysts can form again if predisposing factors are not eliminated. Therefore, in case of functional cysts, a dynamic study of hormonal status and correction of identified disorders are required.

Cystectomy - removal of an ovarian cyst

Access - through 3 mini-punctures

Operation time - 60 - 120 min

Time of hospital stay - 1 day

Cost of the operation: from 30,000 rubles. *

(excluding the cost of anesthesia and hospital stay)

Before the operation of laparoscopy of ovarian cysts, anesthesia is performed. In our Center, this procedure is performed by highly qualified anesthesiologists, using individually selected dosages safe drugs. We perform removal of an ovarian cyst under general endotracheal anesthesia.

Depending on the indications, the doctor performs the operation through laparotomy (through an incision in the abdominal wall) or laparoscopic (through three punctures in the lower abdomen) access. In the latter case, carbon dioxide is injected into the abdominal cavity, providing the surgeon best review area to be operated on, and the operation is performed using a video camera and endoscopic instruments. The doctor monitors the progress of laparoscopic surgery to remove an ovarian cyst using images on the monitor.

The cyst is removed by peeling it out of the capsule. If the tumor is large, the gynecologist-surgeon will first remove its contents with an aspiration needle to reduce the risk of rupture of the cyst capsular membrane. After removing the tumor, the doctor coagulates the bleeding vessels and places sutures at the incision sites. The removed tissue is sent for histological analysis to the Center's laboratory. The patient is transferred to a comfortable room in our hospital.

Other operations for ovarian cysts

If the clinical situation allows, the Center’s surgeons strive to perform laparoscopic operations, as they can reduce tissue trauma and significantly shorten the recovery period. In addition, it is important for surgeons to preserve the woman’s organs and their functions. However, if this is not possible (significant volume of the cyst, risk of developing a cancerous tumor, etc.), our doctors also perform other operations:

Ovarian resection. The intervention involves removal of the cyst and excision of ovarian tissue to prevent relapse.
Ovariectomy. The cyst is removed along with the ovary on which it formed. The operation is performed for large tumors or inflammatory processes in the ovary.
Adnexectomy. During the intervention, the cyst is removed along with the uterine appendages: ovary and fallopian tubes. Our doctors perform both unilateral and bilateral (according to strict indications) adnexectomy.