Ovarian Cystectomy

This article focuses on ovarian cystectomy. 

An ovarian cystectomy is a surgical procedure for the removal of one or more cysts from one or both ovaries. This is done under general anaesthesia by:

1. Laparoscopy (keyhole): this surgery usually involves a 1cm cut in your umbilicus and three to four 0.5cm cuts in your abdomen. A laparoscope (camera) is inserted through your umbilicus, and the pelvis inspected. The cyst is then removed from the ovary, deflated and removed from the umbilical incision.
2. Laparotomy (open): this surgery usually involves either a horizontal (similar to that of a caesarean section) or vertical abdominal incision, and is typically done if the ovarian cyst is too large/ solid for laparoscopy to be performed, or is suspicious for cancer.

In rare cases, a cystectomy may be technically difficult (e.g. very stuck to the ovarian tissue) and an oophorectomy (removal of ovary) may be required for proper treatment. Ovarian cysts may also recur in the future, requiring repeat surgery.

The risks of an ovarian cystectomy may include:

• Pain and bruising around incisions
• Abdominal bloatedness, shoulder tip pain
• Adhesions (scar tissue) which may form within the pelvis and around the site of surgery
• Anaemia due to blood loss 
• Difficulty or delay with urination or with bowel movements in the initial recovery period
• Wound infection, delayed healing or keloid scar formation
• Possible reduction in ovarian reserve 
• Damage to the bladder and/or the ureter 
• Pelvic infection or abscess
• Deep venous thrombosis (blood clot in the leg) or pulmonary embolism (blood clot in the lung)
• Serious adverse reactions to general anaesthesia, including cardiorespiratory complications
• Death: the risk is approximately less than 3-8 in 100,000

The alternative of surgery for an ovarian cyst include observation and regular ultrasound scans to monitor for changes in the cyst – this may not be suitable for all types of cysts and you should speak to your gynaecologist about your options.