Lap Ovarian Cystectomy

Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries — each about the size and shape of an almond — on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years.

Many women have ovarian cysts at some time. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatment within a few months.

However, ovarian cysts — especially those that have ruptured — can cause serious symptoms. To protect your health, get regular pelvic exams and know the symptoms that can signal a potentially serious problem.

Symptoms

Most cysts don't cause symptoms and go away on their own. However, a large ovarian cyst can cause:

  • Pelvic pain — a dull or sharp ache in the lower abdomen on the side of the cyst
  • Fullness or heaviness in your abdomen
  • Bloating

You have to seek medical attention when there is

  • Sudden, severe abdominal or pelvic pain
  • Pain with fever or vomiting
  • Signs and symptoms of those of shock — cold, clammy skin; rapid breathing; and lightheadedness or weakness.

Most ovarian cysts develop as a result of your menstrual cycle (functional cysts). Other types of cysts are much less common.

Functional cysts

Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate.

If a normal monthly follicle keeps growing, it's known as a functional cyst. There are two types of functional cysts:

  • Follicular cyst. Around the midpoint of your menstrual cycle, an egg bursts out of its follicle and travels down the fallopian tube. A follicular cyst begins when the follicle doesn't rupture or release its egg, but continues to grow.
  • Corpus luteum cyst. When a follicle releases its egg, it begins producing estrogen and progesterone for conception. This follicle is now called the corpus luteum. Sometimes, fluid accumulates inside the follicle, causing the corpus luteum to grow into a cyst. Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.

Other cysts

Types of cysts not related to the normal function of your menstrual cycle include:

  • Dermoid cysts. Also called teratomas, these can contain tissue, such as hair, skin or teeth, because they form from embryonic cells. They're rarely cancerous.
  • Cystadenomas. These develop on the surface of an ovary and might be filled with a watery or a mucous material.
  • Endometriomas. A chocolate cyst also known as endometrioma is a sac or pouch growing on the ovary that contains fluids and sometimes semi-solid material too, in which case it may be referred to as a complex ovarian cyst. In simple words, a chocolate cyst is a blood-filled cyst found in the ovaries.
    Many women are affected by chocolate cyst at some point in their lives usually before menopause. Endometrioma is one of the estrogen-dependent gynecological diseases affecting about 5% to 10% of women of reproductive age.
    A chocolate cyst forms when an endometrial tissue (tissue from the inside surface of your uterus) abnormally attaches and grows in the ovaries, as it can with endometriosis. These patches of endometrial cells may form small cysts that multiply into even more cysts when stimulated by menstrual hormones. In the event of no pregnancy, the endometrial tissue usually breaks up from the body during menstrual bleeding. However, in the case of endometriosis, this doesn't happen and instead, the blood accumulates and irritates the surrounding tissue.
    The endometrial tissue inside the ovarian cyst responds to monthly hormones. This tissue bleeds and fills the interior of these cysts with un-clotted blood. Chocolate cysts get their name from dark old blood which is black, tarry and thick, grossly resembling chocolate. Other names for chocolate cyst are endometrial cyst, endometrioma cyst, and chocolate ovarian cyst.
    The symptoms of chocolate cyst are similar to those of endometriosis since the underlying disease is the same, but all cases are individual. As with most conditions, we all react differently. With cysts, some women, regardless of how long the cysts have been present, will have severe symptoms while other women will have little or no symptoms at all. Thus, the extent and severity of symptoms do not always correlate with how far endometrioma has progressed.
    A small incision will be made just below the navel. Next, a laparoscope will be inserted. This is a thin tube with a camera on the end. To allow the doctor to better view the organs, carbon dioxide gas will be pumped into the abdomen. The laparoscope will be used to locate the cyst. When it is found, 1 or 2 more incisions will be made. Surgical instruments will be inserted to remove the cyst. Tissue may be removed for testing. If cancer is found, both ovaries may need to be removed. After the cyst is removed, the instruments will be removed. The incision area will be closed with stitches or staples.
    In some cases, the doctor may switch to an open surgery . During an open surgery, a larger incision will be made in the abdomen to do the surgery.