Laparoscopic Surgery for Ovarian Cysts: What to Expect

Ovarian cysts are common fluid-filled sacs that can develop on or within an ovary, particularly in women of childbearing age. While most are benign and resolve without symptoms, some can rupture, grow very large, or cause the ovary to twist (torsion), necessitating medical intervention. When removal is required, laparoscopic surgery, or "keyhole surgery," is a common and highly effective minimally invasive procedure.

What Is Laparoscopic Surgery?

Laparoscopic surgery is a minimally invasive technique for removing ovarian cysts, involving one or more small abdominal incisions. This approach offers various advantages over traditional open surgery, including:

• Less pain
• Shorter hospital stays
• Smaller scars
• Faster recovery
• Reduced internal trauma
• Less blood loss and lower risk of haemorrhage

When Is Laparoscopic Surgery Recommended for Ovarian Cysts?

Laparoscopic surgery for ovarian cysts is often considered after an initial period of watchful waiting. Factors to consider include:

• Significant Size or Rapid Growth: Cysts that are large or are growing quickly.
• Persistent or Severe Symptoms: When the cyst causes chronic or severe pelvic pain, or other symptoms that disrupt daily life.
• Suspicious Imaging Features: If an ultrasound or other imaging reveals characteristics that raise concern for malignancy or complex pathology.
• Unlikely Spontaneous Resolution: For types of cysts that are known to be less likely to disappear on their own.
• Emergency Conditions: In acute situations, such as ovarian torsion (where the ovary twists, cutting off blood supply) or a ruptured cyst, which can cause severe pain and internal bleeding.

How to Prepare for Laparoscopic Surgery

Before laparoscopic surgery for ovarian cysts, your surgeon will provide detailed instructions to ensure you're fully prepared. These include:

• Medical Evaluation: You will undergo a thorough medical check-up, including blood tests, urine tests and imaging to confirm you are fit for surgery.
• Medication Review: You may need to temporarily stop certain medications, supplements or herbal remedies, especially those that can increase complication risks like blood thinners.
• Smoking Cessation: If you smoke, you will be strongly advised to quit several weeks before the procedure to improve healing.
• Alcohol Consumption: Limit or avoid alcohol in the days leading up to your surgery.
• Healthy Diet: Focus on a balanced, nutritious diet to support your body's recovery process.
• Arrange for Support: Since you will be under anaesthesia, plan for someone to drive you home and assist you during the initial 24 hours post-surgery.
• Fasting: To ensure your safety under anaesthesia, you will need to refrain from eating or drinking anything before your procedure within a specified timeframe.

What to Expect During the Procedure

Laparoscopic ovarian cyst surgery typically takes 30 minutes to 2 hours, depending on its complexity. Here is a step-by-step overview of the process:

• The procedure is performed under general anaesthesia, ensuring you will be asleep and feel no pain throughout.
• Once anaesthesia is administered, the surgeon makes a few small incisions, usually less than 1 centimetre each, in your abdomen.
• Gas is gently introduced through one of these incisions to inflate the abdominal cavity, providing the surgeon with a clearer view.
• A thin, lighted tube called a laparoscope, equipped with a tiny camera, is inserted through one of the incisions. This transmits real-time images to a monitor.
• Through the other incisions, specialised instruments are inserted to carefully remove the cyst.
• The surgeon removes the cyst while preserving as much healthy ovarian tissue as possible.
• Finally, once the cyst is removed and instruments are withdrawn, the incisions are closed with dissolvable stitches or surgical glue.

What Is the Recovery Process Like?

Upon waking, patients will be monitored in a recovery area as the anaesthesia wears off. Most patients are discharged the same day unless further observation is required.

To support proper healing, heavy lifting, strenuous activities, and sexual intercourse must be avoided for a few weeks. While many can return to work within 1 to 2 weeks, full recovery typically takes 4 to 6 weeks.

What Are the Possible Risks or Complications?

While laparoscopic surgery is generally very safe with a lower risk of complications compared to open surgery, it is important to acknowledge that, like all surgical procedures, it carries some potential risks. Though rare, these can include:

• Infection: This can occur at the incision sites or internally within the body.
• Bleeding: There is a possibility of bleeding both during the surgical procedure and in the post-operative period.
• Damage to Surrounding Organs: In rare instances, there is a risk of injury to nearby organs such as the bowel, bladder, or major blood vessels.
• Cyst Recurrence: Unfortunately, even after removal, there is a possibility that new cysts may develop in the future.

For many, the benefits of laparoscopic ovarian cyst surgery outweigh its risks, especially when performed by an experienced surgeon. This minimally invasive approach offers advantages like less pain, faster recovery, and minimal scarring.

If you are experiencing symptoms from an ovarian cyst, please do not hesitate to book a consultation with a gynaecologist. Contact us today for a detailed assessment.