Ovarian cystectomy: surgery
An ovarian cyst is a formation in the form of a fluid-filled cavity in one of the ovaries are small paired organs located on either side of the uterus. A cyst is not a tumor, as it has other causes and mechanisms of formation. However, this disease can cause serious complications for women’s health, including infertility, and therefore requires close attention and appropriate treatment. Surgical removal of the cyst with preservation of healthy tissue of the ovary called a cystectomy.
Modern methods and tools to carry out the operation with minimal disruption of the integrity of the patient’s organs. After cystectomy in most cases the ovary as the female sex gland retains its functionality, so in a few months resumed the woman’s ability to conceive and pregnancy.
What is a cyst?
Cystic tumor arises from cancer, when disturbed mechanism of the outflow of secretions from her body. Cause of pathology can be a blockage of the excretory duct or the surplus produced by the ovarian secretion. As a result, fluid accumulates in the capsule of the gland, stretching it and forming a cystic bladder. Over time it increases and can reach considerable size.
The same mechanism is formed functional ovarian cysts — follicular and luteal. Due to a number of hormonal failures the dominant follicle does not rupture during ovulation and the egg comes out of it into the uterus. Abnormal follicular development may continue for several cycles, as a result, the surface of the ovary becomes uneven. In this case we speak about polycystic ovarian syndrome. Similarly, luteal cyst is formed, in other words luteum cyst.
The contents of the bubble can have a different consistency, from liquid to thick in some cysts, such as endometrial, accumulates clotted menstrual blood.
As you can see, the cause of tumors becomes abnormal proliferation of cells, and stretching of the capsule of the gland under pressure generated within the liquid. Thus, it is not a malignant pathology.
How dangerous is ovarian cysts?
However, to ignore the cyst is impossible. Tumor indicates a serious dysfunction of the body. In polycystic ovary ovulation occurs egg, hence a woman suffering from this syndrome cannot get pregnant. Infertility is one of the major symptoms and complications of cysts the gonads.
Pathology affects the normal flow of the female menstrual cycle, graph of menstruation strays, they become rare or disappear altogether. In some cases, appear dysfunctional uterine bleeding, not related to reproductive function of the body.
In addition, cysts of large size exert physical pressure on adjacent organs, disrupting their work, causing pain, impairing the health of women. Perhaps the development of critical conditions: torsion legs cysts or rupture of the cyst capsule which require urgent medical aid.
The cyst is not the problem that you can just pull the plug. You will need a thorough full diagnosis and judicious treatment.
Treatment of cystic pathologies of the gonads
The purpose of therapeutic interventions should be based on the completed analyses and research. Careful diagnosis is needed to determine the type of cystic education, its nature, size and precise location in the structure of the ovary. For this purpose, techniques hardware rendering of the body (ultrasound, CT). It is important to ensure the purity of the process.
In some cases it is quite conservative drug therapy: hormonal drugs for the correction of menstrual and endocrine disorders, stimulants of ovulation.
But often drugs are ineffective and are unable to reverse or at least suspend the development of cysts. In this case, drastic measures are needed — the surgical removal of the tumor.
Surgery ovarian cysts
There are several techniques of operation, different method of penetration into the abdominal cavity and the scale produced by manipulation. How it will be produced by the intervention, the surgeon determines based on the type, size, location of the cyst (or multiple cysts) and its potential cancer transformation.
Surgical technique with the ovarian cyst:
- cystectomy — husking tumors with maximum preservation of healthy tissues of the body;
- wedge resection — excision of a triangular portion of the ovary along with pathology.
- oophorectomy — removal of the affected reproductive glands whole;
- adnexectomy — complete removal of the ovary together with the fallopian tube.
Access to the body cavity through the abdominal incision (traditional laparotomy) or laparoscopically (through several punctures).
Indications for cystectomy
Cystectomy is the most gentle surgery to remove ovarian cysts. This technique preserves the entire structure of the body and its normal function, which is especially important for women of reproductive age who plan pregnancy in the future.
Conduct the intervention with this technique is possible if the fabric body is not affected by the pathological process and confirmed the benign nature of the tumor. The husking be movable unilocular cyst with clear margins.
Removed the cyst and its contents necessarily analyzed on the basis of which is the final diagnosis.
Laparoscopic cystectomy ovarian
Preparation of the patient for surgery standard: common tests, the hungry period in the evening before the procedure, cleansing enema.
Laparoscopic access to a body cavity of the patient is carried through the three (sometimes four) puncture of the abdominal wall, in which surgical instruments are inserted. The sizes of the punctures are relatively small: 10 mm — above the navel (umbilical access for optics), 5mm on each side.
To control the process of operation, the doctor can use a camera, the image which is displayed on the monitor.
To change the position of the uterus during the operation, using a special manipulator.
- To create a working space in which to move the manipulators into the body cavity is pumped 3-4 liters of carbon dioxide, raising the abdominal wall.
- Clip the ovary is fixed in the desired position.
- Carefully cut the thin crust of the ovary. The surgeon will use special scissors or a hook and electrocoagulator. At this stage it is extremely important not to damage the primordial follicles.
- Expanding the edges of the wound, the cyst husk of its capsule, using for the preparation of a tissue dissector, the reindeer or the method of equidistance.
- The extracted tumor is placed in a container and sent for analysis.
If the size of the cysts significant (more than 8 cm), before the husking is carried out aspiration of its contents. Due to this, no drops malicious cystic fluid on the inside of the operated will not be spilled.
Preserving the integrity of the tumors during the operation, making the intervention as effective as possible and minimizes the possible complications (e.g., adhesions).
To operated sex gland healed as quickly as possible, it is important to match the edges of the wound. If this can not be achieved, superimposed surgical sutures.
Recovery after surgery
Laparoscopic cystectomy sexual glands — the most sparing method of surgical intervention. Recovery after surgery takes place within two weeks. On the third day in the absence of contraindications, the patient can leave the hospital.
In the first days after the intervention the pain in the lower abdomen. To help women use pain-relieving medications.
Within a few weeks after surgery are advised to avoid heavy physical exertion and sexual contact. It is necessary to conduct dynamic monitoring of the gonads.
Three months after cystectomy of the ovary, a woman can get pregnant, since the reproductive organ is fully restored.