Laparoscopic Management of Ovarian Dermoid Cysts: The Safety and Efficacy

Objective: The efficiency and safety of laparoscopic surgery in the management of ovarian dermoid cyst. Material and Methods: Our study included forty patients with diagnosis of unilateral or bilateral dermoid cysts between August 2006 and May 2008 underwent laparoscopic removal of dermoid cysts. All cases were performed at department of obstetrics and Gynecology, women's health centre, Faculty of Medicine, Assiut University. All specimens removed in all cases were sent for pathological examination to confirm the diagnosis. Results: The mean patient age was 26.4 years (range 1936), 25 patients were nulliparous and 15 were multiparous. Thirty-six patients had unilateral cyst (90%) (RT side69.4% and Lt side 30.6%) and 4 patients had bilateral cysts (10%) for a total of 44 dermoid cysts. The mean cyst diameter measured by Transvaginal ultrasonography was 6.5 ± 1.4 cm (mean±SE) range 5.5-7.6 cm. There were additional procedures beyond dermoid cyst removal consisted of treatment of endometriosis (5 cases), adhesolysis (3 cases) and non dermoid cysts (2 cases). Intraoperative spillage rate of dermoid cyst contents was 19 cases (47.5%). There is no evidence of recurrence in the fellow-up of all patients within six months. Six patients became pregnant during the follow-up period. Conclusion: Using strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure. Spillage of the contents of the dermoid cyst does not lead to any complication; perhaps this is due to the liberal irrigation of the peritoneal cavity.