Patient Presentation: Large Abdominal Lump
27 yr old lady PoA1Lo presented with a large abdominal lump.
USG s/o
- Simple ovarian cyst of size 21cm ×20cm ×13cm.
- Unilocular.
- without any nodularity, solid component or septations.
- No ascites & lymphadenopathy
CT scan plain & contrast done
Similar findings were noted
Tumor markers
Tumor markers were within normal range ( Ca125=7.5 U/ML: RMI=7 )
Patient and her parents insisted on the Laparoscopic surgery. (Pt had a plan of her second marriage so apart from the disease, scar was another concern for her) surgical plan discussed in detail.(records maintained)
Operative notes:
Low dorsal lithotomy position given, 11mm TC inserted through open technique, (10-12 cm above the umbilicus) pneumoperitoneum maintained at minimal level. Abdominal cavity screened, no suspicious lesions seen.
Under vision 6mm ancillary TC inserted directly into the cyst , 3.9Lt clear fluid suction done through the same port.5 mm laparoscope inserted through same port, smooth uniform inner cystwall noticed. Rt.Salpingooophorectomy performed.
Abdo- pelvic region screened again but no suspicious lesions seen. Supraumbilical Incision widened upto 3cm, endobag used. Specimen of cyst, peritoneal washings, random omental & peritoneal biopsy sent for cytology and histopath .
Histopath report was s/o Benign serous cystadenoma.
With the proper patient selection, size of the ovarian cyst should not constitute a contraindication for Laparoscopic surgery.