A laparoscopic ovarian cystectomy is a minimally invasive surgery to remove cysts that can form inside the ovaries. This surgical procedure is performed by one of our highly experienced surgeons skilled in OB/GYN laparoscopic techniques. It is performed under general anesthesia via two or three tiny 5mm incisions in the abdomen and one at the belly button, which one or more ovarian cysts are removed from.
What is an ovarian cyst?
Ovarian cysts are basically fluid-filled sacs that form within the ovary. They are fairly common among women of all ages and are usually benign.
While most cysts resolve on their own, some ovarian cysts can become symptomatic and cause bleeding, pelvic pain, difficulty with conceiving, and, in certain cases, can even become cancerous.
Non-cancerous cysts can be removed surgically while leaving the ovaries intact so that you can still conceive a child. But if a cyst is cancerous, then both ovaries must come out because, once a malignant cyst has been surgically removed, there is still a chance that cancer might grow back either on the operated ovary or on the other one.
When should an ovarian cyst be removed?
There are a number of reasons that might make you a candidate for an ovarian cystectomy (cyst removal). If you have:
A cyst or mass in both ovaries
A cyst that hasn’t shrunk or disappeared within 3 months
A cyst that’s greater than 3 inches in diameter
A cyst that appears abnormal
A cyst that your doctor suspects may be malignant
If you fall into one of the following groups and are diagnosed with an ovarian cyst, you might be a candidate for an ovarian cystectomy:
women taking birth control pills
post-menopausal women
young females who have not yet begun to menstruate
In order to better understand the characteristics of your ovarian cyst, we might order some diagnostic tests before your procedure to determine the shape and size of the cyst or cysts, whether they’re fluid-filled (known as simple cysts) or solid or a mix of both fluid-filled and solid (known as complex cysts).
Identifying these characteristics is important because it can help determine if a cyst is benign (non-cancerous) and warrants observation and close follow-up (as is the case with most simple cysts) or if further testing is necessary to determine if a cyst is malignant and requires removal of the ovary.
Diagnostic tests can include:
Ultrasound: this is a painless non-invasive test that involves passing a wand over your abdomen that has been coated with a gel to facilitate gliding. By tracking sound waves, we can determine the shape (regular or irregular), size, and composition (solid, fluid-filled, or both) of the ovarian masses to help guide our treatment plan.
MRI/CT Scan: These are two kinds of imaging studies that provide a more in-depth view of the pelvic cavity using either magnetic fields or radiation.
Blood tests: we may order pre-op bloodwork that can include a pregnancy test (if there’s any possibility that you might be pregnant), checking your hormone levels (they may play a role in tumor growth) and measuring your CA-125 protein levels (which can be high in the presence of ovarian cancer).
What happens during a laparoscopic ovarian cystectomy?
At the Outpatient Hysterectomy Center, laparoscopic ovarian cystectomies are performed under general anesthesia.
Your surgeon makes two or three tiny 5mm incisions in your abdomen (one near each hip bone and possibly a third incision just below your navel) through which slim surgical instruments are introduced to perform the laparoscopic surgery.
First, a thin flexible tube with a lighted camera at the tip is inserted in your belly button incision to guide your surgeon throughout the surgery. Other specialized tools are then introduced through the other small incisions (called portals) and these tools are used to trim and remove any unwanted tissue.
Once the ovarian cyst or cysts are removed, the instruments are withdrawn, each portal is closed with a single absorbable stitch and then covered with a bandage. After it heals completely, in about six months, you will probably not be able to even see that you ever had surgery!
What happens after a laparoscopic ovarian cystectomy?
After our outpatient ovarian Cystectomies, patients always go home the same day. This is very different than patients who have a traditional procedure as they will require a two or three-day hospital stay. Though an overnight stay is required for many laparoscopic surgeries that is never the case with us.
In the days following our procedure, you’ll transition from resting to light exercising, being careful to avoid any strenuous activities, and lifting. Nearly all of our patients are 100% back to their normal routine within a couple of weeks after surgery.
We will see you for your first post-op follow up one week after your procedure to check your progress. At that time, we will discuss when you can go back fully to your and resuming sexual intercourse.
What are the advantages of having laparoscopic surgery?
Our laparoscopic surgery offers many advantages over a traditional open abdominal surgery that uses a large bikini line incision.
These advantages of a laparoscopic ovarian cystectomy over open surgery are many, including:
Requiring just three tiny incisions that when healing, are either barely visible or simply undetectable.
Having a shorter surgery with less anesthesia exposure (because working through tiny incisions means less time is spent getting in and out of your pelvic region)
Decreased blood loss (due to much smaller incisions and less manipulation of your pelvic organs)
Less pain after surgery (due to smaller incisions that leave the abdominal muscles mostly intact)
Giving your surgeon a better view within your pelvic area as compared to with a single abdominal incision (because the laparoscope can be positioned in several different locations within your pelvis, offering a 360-degree view of some structures)
A quicker recovery time (most patients are up and about the day after surgery and usually back to their regular routine within two weeks)
When it comes to gynecological surgery, there is no substitute for experience
Dr. Thais Aliabadi and Dr. Ramon Yera are recognized experts with an international reputation in minimally invasive OB/GYN surgery, having performed thousands of laparoscopic procedures over twenty years.
The recipients of dozens of awards for medical excellence and patient satisfaction, Drs. Aliabadi and Yera have joined forces to create the Outpatient Hysterectomy Center, a world-class surgical practice dedicated exclusively to women’s health.
Doctors Aliabadi and Yera specialize in leading-edge minimally invasive surgeries that offer patients shorter recovery times, less pain, and the least interruption to their daily lives.
If you are considering gynecologic surgery, you owe it to yourself to learn about the minimally invasive surgical treatment options available today.
Schedule a consultation today to have a candid conversation with us about your particular condition in a discreet and non-intimidating setting, where they can address all of your questions and explore what surgical procedure might be most suitable for you.
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What are the potential risks involved with having the procedure performed outside of a hospital setting?
Having the procedure performed outside a hospital setting may pose risks due to limited resources for emergencies, potential delays in accessing specialized care, and the absence of immediate hospital facilities if complications arise.
Can insurance plans typically cover the cost of having the procedure performed on an outpatient basis?
Insurance plans typically cover the cost of outpatient procedures. However, coverage specifics vary among providers, so it's essential to check with your insurance company to determine if they will cover the cost of having the procedure performed on an outpatient basis.
Will undergoing the procedure have any long-term effects on one's ability to conceive?
The laparoscopic ovarian cystectomy procedure typically does not have long-term effects on one's ability to conceive. Each case is unique, and your doctor can provide personalized information regarding fertility concerns post-surgery. Regular follow-ups with your healthcare provider are essential.
What can patients expect in terms of recovery time following the procedure when performed outside of a hospital setting?
Patients undergoing a laparoscopic ovarian cystectomy outside of a hospital setting can expect a quicker recovery time compared to traditional open surgery. Most patients are up and about the day after the procedure and usually back to their regular routine within two weeks.
Are there any specific post-operative care instructions patients should follow after having the procedure done on an outpatient basis?
After an outpatient laparoscopic ovarian cystectomy, patients should gradually resume light activities, avoid strenuous exercise and lifting, and closely follow their surgeon's guidelines. Recovery is typically quicker with minimal pain and smaller incisions compared to open surgery.
Is it possible for the condition to reoccur even after undergoing the procedure?
After undergoing a laparoscopic ovarian cystectomy, there is a possibility of the condition recurring. In cases where one ovary is removed due to a malignant cyst, there is a risk of cancer returning either in the remaining ovary or elsewhere in the body. Regular follow-ups post-surgery are crucial.
What pre-op tests are required?
Before a laparoscopic ovarian cystectomy, pre-op tests may include bloodwork for pregnancy, hormone levels, and CA-125. Imaging tests like ultrasounds can determine characteristics of the cyst, aiding in determining benign or malignant nature. This helps guide treatment decisions for the cyst removal procedure.
How is the surgery scheduled?
Surgery scheduling at the clinic involves thorough preoperative assessments, patient education, and coordinating with the surgical team. The process includes selecting a suitable date, ensuring medical clearance, discussing preparation instructions, and providing detailed post-operative care information for a smooth transition.
Who performs the surgery?
The Outpatient Hysterectomy Center, led by Dr. Thais Aliabadi and Dr. Ramon Yera, specializes in minimally invasive gynecological surgeries. Operating together for over twenty years, they have extensive experience in performing laparoscopic procedures, ensuring expert care and successful outcomes for their patients.
What post-op pain is expected?
Expect mild to moderate postoperative pain after laparoscopic ovarian cystectomy, managed with prescribed pain medications. Discomfort may accompany moving or sitting up, gradually improving over a few days. Activity restrictions initially, but normal routines resume within two weeks post-surgery.
How long until normal activity?
Most patients are up and about the day after surgery and usually back to their regular routine within two weeks.
What surgical approach is used?
The surgical approach used for an outpatient laparoscopic ovarian cystectomy is minimally invasive. This method involves three tiny incisions resulting in a shorter surgery, decreased blood loss, less pain, and quicker recovery compared to open surgery.
Are post-op check-ups necessary?
Post-op check-ups are crucial to ensure proper healing, monitor any complications, and address concerns. Follow-ups allow for assessment of recovery progress, adjustment of treatment plans if needed, and provide guidance for optimal post-surgery care. Regular monitoring in the post-operative phase can prevent complications and promote overall well-being.
Any dietary restrictions post-surgery?
After surgery, dietary restrictions usually include avoiding heavy, greasy foods, opting for a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Hydration is important. Consult your physician for personalized guidance.
How to recognize post-op complications?
It is essential to recognize post-op complications by monitoring for signs such as fever, increased pain, redness or swelling, abnormal bleeding or discharge, difficulty breathing, or signs of infection. Contact your healthcare provider immediately if any concerning symptoms arise after surgery.
Is a biopsy done routinely?
Biopsies are not done routinely. They are typically recommended based on specific indications such as concerning findings on imaging studies, abnormal blood tests, or suspicious physical exam findings. The decision to perform a biopsy is made on a case-by-case basis after considering all relevant clinical information.
Are follow-up ultrasounds common?
Yes, follow-up ultrasounds are common post-laparoscopic ovarian cystectomy to assess healing and ensure the cyst hasn't returned. Regular monitoring aids in detecting any recurrence or new issues promptly.
What pain management is offered?
Different types of French Russian and Swedish massage techniques are used for pain management. These methods involve soft tissue manipulation, deep tissue massage, and trigger point therapy. Additionally, relaxation techniques such as guided imagery, breathing exercises, and meditation are incorporated to alleviate discomfort.
How to prepare for surgery?
Preparing for surgery involves diagnostic tests to assess cyst characteristics, pre-op blood work for hormone levels and CA-125, ensuring appropriate anesthesia, and understanding the procedure. Post-surgery, activities should be limited, gradually increasing as advised for optimal recovery.
When to resume exercise?
It is important to transition from resting to light exercising after a laparoscopic ovarian cystectomy. Avoid strenuous activities and lifting initially. Typically, most patients are up and about the day after surgery and can return to their regular routine within two weeks.
Any limitations post-surgery?
After a laparoscopic ovarian cystectomy, you may experience limitations post-surgery such as restrictions on strenuous activities, lifting heavy objects, and engaging in intense workouts. It's essential to follow your doctor's instructions for a smooth recovery process to minimize complications and ensure proper healing.
What supports healing post-surgery?
Healing post-surgery is supported by follow-up appointments, rest, light exercise, avoiding heavy lifting, and a healthy diet. Minimally invasive surgery, like laparoscopic cystectomies, offer quicker recovery due to smaller incisions, less anesthesia exposure, decreased blood loss, and less pain post-operation.
How to manage scar care?
To manage scar care effectively, it's important to keep the area clean and moisturized. Apply silicone-based gels or sheets, massage the scar to improve circulation, protect it from the sun, and consider treatments like laser therapy or steroid injections for more severe scarring. Regularly following these practices can help minimize the appearance of scars over time.
Are drains used post-surgery?
Yes, drains are typically not used post-surgery for a laparoscopic ovarian cystectomy, as it is a minimally invasive procedure with smaller incisions, leading to decreased blood loss and faster recovery. This approach aims to minimize discomfort and improve the overall surgical experience.
When are stitches removed?
Stitches are removed in the days following an ovarian cystectomy. At the end of the procedure, each incision is closed with a single absorbable stitch, covered with a bandage. This allows for a smooth transition from resting to light exercising post-surgery.
Is hormonal treatment required after?
Hormonal treatment after an ovarian cystectomy may be necessary depending on the individual's hormonal balance and specific medical needs. It's essential to follow post-operative instructions provided by the healthcare provider for optimal recovery and management.
How soon to travel post-op?
It is essential to consult your physician before traveling post-op. Generally, patients can travel soon after laparoscopic ovarian cystectomy, but it's crucial to get clearance from your doctor to ensure safe travel, taking into account individual recovery progress and any specific travel considerations.
Are post-op hormones necessary?
Post-op hormones may be necessary depending on individual circumstances, such as hormone levels and overall health. Consult with your healthcare provider to determine if hormone therapy is recommended post-operatively for your specific situation.
Can cysts affect hormone levels?
Ovarian cysts can potentially impact hormone levels, as they may disrupt the normal hormone production and regulation processes within the ovaries. Hormone levels may be influenced by the presence and characteristics of ovarian cysts, which can lead to various symptoms and complications.
Any alternatives to surgery?
Alternatives to surgery for ovarian cysts may include watchful waiting, hormonal contraceptives, pain management, and lifestyle modifications. Discuss with your doctor to determine the best non-surgical approach based on your specific situation.
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