Large Ovarian Cyst - Laparoscopic Entry: A Case Report

This report is aimed at introducing a simple technique to improve safety in drainage of large ovarian cyst managed with laparoscopic techniques. A 31-year-old, nulliparous woman, presented with a massive unilocular ovarian cyst measuring 22.48 cm in height, 18.92 cm in transverse axis, and 8.03 cm antero posteriorly. She had a normal CA125 level. Entry was done with the open technique (Hasson's) at the midpoint between umbilicus and the xiphisternum (Lee Huang). Through this opening the cyst wall was separated by blind dissection to avoid damage to cyst wall. Then the cyst contents were drained with a Veress needle. Troche was inserted through the same incision and pneumoperitoneum was created allowing a routine cystectomy. The critical step in managing large cysts is safe entry and inducing pneumoperitoneum. Using a simple technique, could improve safety resulting in successful a successful outcome of laparoscopic techniques for large ovarian cysts.