An ovarian cyst can occur in absolutely any woman, and it does not matter at all whether she has given birth or not. This pathology causes severe harm to health, and if it is not treated in a timely manner, severe complications may arise in the future.

Therefore, it is best to begin eliminating it at the initial stage, especially since during this period you can use minimally invasive interventions that do not cause severe harm to health and are not accompanied by complications.

These methods include laparoscopy of an ovarian cyst, which almost never causes complications. In addition, after this therapy, rapid recovery of the body without unpleasant consequences is observed. But still, it is worth carefully considering all the features of this method more carefully.

Features and duration of surgery

If abdominal surgery to remove an ovarian cyst is performed using an abdominal incision, then the laparoscopic surgical method is performed through a small puncture. Therefore, after this procedure there is a rapid recovery process and scars are almost never observed.

In addition, the entire procedure proceeds with minimal pain and without complications. But still, the patient will have to experience a little discomfort and in the future period will need to follow a number of recommendations from the attending physician, which will speed up the recovery period.

Important! It is worth noting that laparoscopic removal of an ovarian cyst is performed under general anesthesia, so during this procedure the woman will not feel any discomfort or all the manipulations that the surgeon will perform.

On average, this procedure lasts from 40 to 90 minutes. The period of this operation depends on the general condition of the patient, the degree of the pathological process, the size of the formations, and the experience of the doctor.

Preparation procedure and necessary tests

Before proceeding with laparoscopic ovary removal surgery, you must first pass the required tests. The standard list includes the following tests:

• Conducting a general urine test;
• A general blood test is taken;
• It is necessary to take a biochemical blood test;
• The level of blood clotting is determined;
• Be sure to determine the blood type and Rh factor;
• An analysis is carried out for the presence of infectious diseases;
• HIV test;
• For hepatitis C and B;
• For syphilis.

At the next stage, a full ultrasound examination of the pelvic organs is carried out, a smear is taken from the vagina to determine the general condition of the microflora, an ECG and fluorography are performed.

Before the operation itself, laxatives are prescribed, and enemas can also be performed to cleanse the intestines. Enemas should be done in the evening on the eve of removal of an ovarian cyst using laparoscopy.

Eating should be stopped 10 hours before surgery, and it is also advisable to stop drinking liquids. At the time of the operation, the stomach must be completely empty.

How is the operation performed?

Laparoscopy of an ovarian cyst compared to abdominal surgery has a low level of trauma. In addition, this method is carried out using a special video device, which is equipped with lenses with multiple magnification. During this method, the doctor sees the entire area as if under a microscope, so it ensures a successful operation.

Features of the operation:

1. The surgery is performed under general anesthesia. Therefore, during the surgical intervention the patient does not feel any discomfort;
2. The surgeon makes small incisions in the form of punctures, into which he inserts equipment with video devices. Through these punctures the operation itself is carried out using instruments;
3. At the beginning of the operation, carbon dioxide is supplied, which ensures straightening of the abdominal cavity and illuminates all internal organs;
4. Usually two punctures or incisions are made. A video device is inserted into one, and devices for performing surgery into the other;
5. Using the image that the video device sends from the abdominal cavity to the monitor, the doctor performs the operation without harming other healthy tissues and organs;
6. After this, the gas is released, stitches and bandages are applied to the punctures.

Postoperative period

Important! After laparoscopy of an ovarian cyst, the patient must remain in the hospital for a period. During this period, the sutures must be treated, antibiotics and vitamins are prescribed, and painkillers may also be indicated. All this is required to carry out prophylaxis and prevent the recurrence of the cyst.

Features of the postoperative period:

• After surgery to remove an ovarian cyst, complications and unpleasant consequences rarely occur, and recovery is usually quick and easy. Compared to the abdominal method of surgery, the incidence of complications after this type of operation is quite low;
• However, during the first 3-4 days after this procedure, pain may be felt at the site of the incisions and a state of general weakness;
• Due to the fact that the phrenic nerve is irritated by air, aching pain in the shoulder area may appear. Constipation and bloating of the abdominal area may also occur;
• On the 5th day after laparoscopy of the ovarian cyst, the sutures are removed;
• After discharge, hormonal therapy is recommended, in which hormonal oral contraceptives are used;
• For control, a repeat ultrasound examination is required.

Menstruation usually occurs at the scheduled time after surgery. At first, pain may appear, and the discharge may be profuse. But all this is a temporary phenomenon that quickly passes.

After laparoscopic removal of the cyst is performed, the doctor will prescribe important measures that will ensure rapid recovery of the body after surgery to remove the cyst on the ovary.

During the postoperative period, the following recommendations should be followed:

1. It is necessary to wear tight stockings or wrap your legs with an elastic bandage. This is required for the prevention of thromboembolic diseases;
2. After recovering from anesthesia, it is necessary to get on your feet and walk within 5 hours, even if it is difficult;
3. It is best to abstain from intimacy for a month;
4. You should avoid increased physical activity, do not lift weights exceeding 3 kilograms;
5. At first, you should take a shower instead of a bath.

Important! It is worth remembering that at first it is not recommended to sunbathe in the sun, go to the solarium, visit baths and saunas, and you should not stay under the sun for a long time.

The recovery period after laparoscopy is about 3 months. During this period, you should strictly follow all of the above recommendations. This will not only speed up recovery, but also prevent the recurrence of the cyst.

Diet

During the first time after surgery, it is recommended to eat only liquid food; it is best to drink broth. During the second day you are allowed to eat jelly and some bread. During the subsequent period, nutrition is expanded due to the introduction of porridges, pureed soups, and steamed cutlets.

Features of nutrition for a month after surgery:

• During the first month, you should avoid eating fried, spicy, fatty, smoked foods, and marinades;
• The diet should be gentle and contain a high level of vitamins;
• All vegetables and lean meats are allowed to be boiled, baked, steamed, stewed, but not fried;
• Sweets, coffee, chocolate, strong tea, and alcoholic beverages are excluded from the diet;
• You can drink kefir, yoghurt, fermented baked milk;
• You should eat in small portions 5-6 times a day.

Complications

Many people are interested in the important question of what the consequences may be after removal of an ovarian cyst. The main complications of laparoscopy include the following conditions:

1. The appearance of postoperative bleeding;
2. Damage to the structure of the ovaries, which are located nearby;
3. Causing wounds to blood vessels when performing punctures;
4. The occurrence of postoperative complications of an infectious nature - thrombophlebitis, pneumonia, peritonitis, and so on;
5. Suppuration of the sutures may occur.

But all these unpleasant consequences occur in rare cases.

Attention, if there is an increase in body temperature to 38 degrees, pain in the lower abdomen, nausea, dizziness, weakness, then in these cases you should urgently consult a doctor.

In any case, laparoscopy is much safer than abdominal surgery, but it is recommended to be performed only at the initial stage of cyst formation. In the final stages, this method will not help get rid of the cyst. Also, do not forget about preoperative preparation and the features of the postoperative period.

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

The ovaries are a very important organ, not only as a source of female reproductive cells, but also due to their hormonal activity, which allows them to maintain the normal functioning of the female body. Any changes in one way or another affect the well-being, the ability to become pregnant and bear fruit, sexual activity, menstrual function and even the appearance of a woman.

The reasons for surgery on the ovaries are a variety of tumor processes, cysts, inflammation, congenital developmental anomalies, etc. Whenever possible, gynecologists choose laparoscopy as the most gentle method of treatment and, at the same time, highly effective.

It happens that after carrying out a variety of examinations, an accurate diagnosis cannot be established, and then specialists prescribe diagnostic laparoscopy of the ovary, during which it is possible to examine the affected organs directly in the pelvic cavity, take their fragments for histological analysis, and, if necessary, immediately perform surgical treatment of pathology.

Laparoscopy compares favorably with conventional open surgery in a number of significant advantages:

• Less traumatic, no large incision or scarring;
• Excellent aesthetic result, which is important for the fair sex;
• Low probability of adhesions after intervention;
• Short recovery period;
• Minimal number of postoperative complications.

Thanks to these features of the operation, many women seek to undergo treatment of ovarian pathology laparoscopically, and this is not only a good cosmetic effect, but also a much shorter recovery period and a low number of complications, including adhesive disease in open surgery, which can lead to and to pain, and even to infertility.

Among the patients who are indicated for ovarian laparoscopy, the majority are young women, some of them have not yet given birth to children, some are nursing mothers, so low trauma and safety of the operation are one of the decisive factors when choosing access to the ovaries.

Laparoscopy makes it possible to carry out the same manipulations as open abdominal surgery, with the only difference that instead of a long incision, which subsequently risks becoming an ugly and rough scar, barely noticeable scars will remain on the abdomen. No one around you, for example, on the beach, will guess about the fact of the surgical treatment, while the scar, visible to everyone, causes considerable psychological discomfort and forces you to hide your stomach where you can get by with an open swimsuit or a short T-shirt.

A kind of disadvantage of laparoscopy may be the need for expensive equipment and trained qualified specialists, but today most clinics not only in large cities, but also in smaller settlements have both, and laparoscopy operations have been put on stream, which makes the technique quite accessible to a wide range of people women who need it.

When is it possible and why not to do laparoscopy?

The reason for prescribing ovarian laparoscopy can be any organ pathology that requires surgical treatment. The only exception is malignant tumors, for which it is safer to perform laparotomy.

Indications for surgical treatment:

Laparoscopy can be performed routinely or urgently. Immediate intervention requires conditions that threaten the life and health of a woman - ovarian rupture with bleeding, torsion of the pedicle of a cystic formation, cyst rupture and pelvic peritonitis. Laparoscopy of ovarian cysts, finding out the causes of infertility, and eliminating adhesions are most often carried out as planned.

Obstacles to laparoscopic treatment of the ovaries may coincide with those for any operation, and may also be due to some features of the laparoscopic surgical technique. These include:

• Severe decompensated diseases of the lungs, heart, liver and kidneys, when anesthesia and any injury pose a serious threat;
• Severe blood clotting disorders;
• Infectious diseases in the acute phase, fever;
• Severe acute inflammation of the pelvic organs, microbial contamination of the genital tract;
• Extreme obesity (due to the need for pneumoperitoneum);
• Diffuse peritonitis;
• Malignant neoplasm or benign tumor over 10 cm.

Many obstacles to laparoscopy are considered relative, so the surgeon evaluates them individually in each case.

Preparing for surgery

Ovarian laparoscopy is performed under general anesthesia, so it is important to properly prepare for it to avoid adverse consequences. If the operation is already planned, the woman is sent to preoperative examination, including blood and urine tests, coagulogram, cardiogram, fluorography, determination of blood group and Rh, tests for hepatitis, HIV, syphilis, ultrasound examination of the pelvis, consultation with a gynecologist with the collection of smears for cervical cytology and determination of microbiocenosis of the genital tract.

If abnormalities are found in the tests, the woman will need to be treated. In the presence of chronic diseases of internal organs, consultation with a therapist, cardiologist or other specialist is necessary to correct the course of the pathology and maximize its compensation.

After careful preparation, on the appointed day, the woman comes to the clinic, where the surgeon who will perform the operation talks with her. Possible risks and contraindications for laparoscopy are clarified once again, the essence and meaning of the intervention is explained to the patient, and a control ultrasound of the pelvis is performed.

The anesthesiologist finds out in detail whether operations have been performed under anesthesia before, whether there are any allergies, and what medications the woman takes on a regular basis. A anticoagulants and antiplatelet agents should be discontinued at least a week before the scheduled date of laparoscopy.

The night before the operation, the patient takes a shower, removes hair from the wall of the abdomen and genitals, does not eat from six o'clock and does not drink at all from 10 p.m. A cleansing enema is performed to empty the intestines.

A few days before laparoscopy, it is advisable to switch to a light diet, excluding foods that contribute to bloating - legumes, cabbage, baked goods, fresh vegetables and fruits. It is optimal to eat porridge, fermented milk products, and lean boiled meat.

An empty intestine facilitates the application of pneumoperitoneum and examination of the pelvic organs through a laparoscope, and complete fasting 10 hours before surgery allows one to avoid vomiting and the entry of gastric contents into the respiratory tract during anesthesia and during recovery from it.

If there is a high probability of infectious complications, broad-spectrum antibiotics and antifungal agents are used, and if a woman has severe varicose veins or a risk of blood clots, she will be recommended elastic leg bandaging during surgery and in the early postoperative period. In case of severe anxiety on the eve of the intervention, sedatives are indicated.

Laparoscopy of the ovaries requires general intubation anesthesia, when a woman's breathing is supported by a ventilator. This is necessary in connection with the use of muscle relaxants, which allow the muscles of the abdominal wall to relax as much as possible. In more rare cases, if there are contraindications, intravenous or epidural anesthesia is used.

During laparoscopy, the woman lies on her back with the head end of the table slightly tilted down, which allows the intestinal loops to be shifted towards the diaphragm and increases visibility and space for manipulation of the ovaries.

Technique for ovarian laparoscopy

The duration of the operation depends on the characteristics of the pathology. On average, it lasts about 40 minutes, but perhaps less, and in difficult cases it lasts for an hour and a half. In general terms, ovarian laparoscopy looks like this:

1. Induction of anesthesia, tracheal intubation, treatment of puncture sites or incisions with antiseptic solutions;
2. 3-4 small incisions up to one and a half centimeters long are made on the abdomen to insert instruments;
3. Injection of carbon dioxide through the first trocar to raise the abdominal wall;
4. Inspection of the image on the monitor, assessment of changes in the appendages and uterus, the condition of the pelvic tissues, removal of a tumor, cyst, stopping bleeding, etc.;
5. Removing instruments, suturing skin incisions and treating wounds with antiseptics.

Video: technique for laparoscopy of ovarian cysts

Laparoscopy of ovarian cyst

If the main goal of the operation is to excise a cystic formation of the ovary, then the surgeon will plan to either remove the cyst itself with maximum preservation of the organ, or the formation with part or the whole ovary.

Thus, the following are possible types of operations for cysts:

• Cystectomy - removal of only the cavity;
• Adnexectomy - excision of the entire affected ovary with the cyst entirely as a single block;
• Resection is the removal of a fragment of an organ in which a pathological formation is detected.

Considering the hormonal activity of the ovary, with any cysts the surgeon will try to preserve the functioning part of the organ as completely as possible. If this is possible, then the cyst with capsule is desquamated, otherwise the neoplasm is removed as economically as possible. If the ovary is completely affected by the disease or atrophied from the pressure of the cystic cavity on it, then it will most likely not be possible to save it, and the surgeon will be forced to completely excise the diseased organ.

Stages of laparoscopy of ovarian cyst:

A prerequisite for laparoscopy of an ovarian cyst is the subsequent referral of the formation’s membranes for pathohistological examination to exclude malignant growth and clarify the structure of the cyst.

Laparoscopy of endometrioid ovarian cyst is carried out similarly to the method described above, when the pathological formation is excised using instruments and a coagulator. If small superficial foci of endometriosis are detected during laparoscopy, they can simply be coagulated. Endometriosis is often accompanied by the formation of adhesions, so during the intervention the surgeon cuts them with scissors or a scalpel.

Laparoscopic removal of an ovarian cyst most often ends with the preservation of a full-fledged organ, which continues to perform a hormonal role and reproduce mature eggs. Cystectomy is one of the most gentle methods of surgery to treat cysts.

Less often, surgeons perform resection of the ovary or its total removal. When the doctor is sure that it is impossible to safely separate the cyst or it is impossible to preserve the pathologically changed ovary, resection is indicated, in which, after capturing the organ with instruments, it is cut off using a coagulator or laser. The altered tissues are removed through the trocar to the outside, and the bleeding vessels are coagulated.

Urgent laparoscopy is necessary for torsion of the cystoma leg. If, upon examination, irreversible changes in the ovarian tissue (necrosis) are noticeable, then total ovarian cancer is indicated. In the case of incomplete torsion and while maintaining normal ovarian tissue, the surgeon may attempt to untwist the cyst stalk and excise only the cystic cavity.

Video: laparoscopy of ovarian cyst

Surgeries for polycystic disease

Laparoscopy for polycystic ovary syndrome is aimed at removing large cysts and activating ovulatory function. Most often, the reason for its implementation is infertility and lack of effect from drug treatment. The main goal of treatment is not only to remove the altered parenchyma, but also to provide conditions for egg maturation, ovulation and fertilization.

For polycystic disease, several types of operations are possible:

• Decortication - when during the intervention the dense sclerosed tunica albuginea is excised, which facilitates the maturation of follicles in the future and the release of the egg from them;
• Cauterization - 6-8 circular incisions are made on the outer part of the ovary up to 1 cm deep into the organ, which enable the growth of the follicle and the maturation of the egg without the formation of a cyst;
• Wedge resection - removal of a wedge-shaped section of tissue in one of the poles of the ovary;
• Endothermocoagulation - insertion of an electrode deep into the organ and formation of up to 15 holes with the electrode;
• Electrodrilling is the excision of many cystic cavities of the cortical layer using an electric current.

Recovery period and possible consequences

The postoperative period for ovarian laparoscopy proceeds well, and after a few days the patient can go home. By the evening of the first day, light meals are allowed, early activation is recommended, which allows you to quickly normalize intestinal motility and prevent complications.

In the first two days, the operated patient may feel unpleasant bloating or pain in the abdomen, shoulder girdle, and back associated with the administration of carbon dioxide. These sensations are short-lived and go away the sooner the woman gets out of bed. Practice shows that thin patients complain of pain more often than overweight women.

Pain after laparoscopy in the area of ​​the appendages and postoperative sutures may require the use of analgesics in the first 1-2 days (analgin, ketorol, parcetamol), anti-inflammatory drugs (ibuprofen), and in case of high risk or already developing infectious-inflammatory changes, after large-scale interventions The woman is prescribed broad-spectrum antibiotics and antifungal drugs.

Due to possible thromboembolic complications in the postoperative period, anticoagulants are administered under the control of a coagulogram, elastic bandages are removed on the first day if the doctor deems it safe.

Recovery after ovarian laparoscopy lasts about a week, the sutures are removed on days 8-10, but you can be discharged home already on the third day after the operation. After discharge, a woman can remain on sick leave for another week or even longer if her condition requires it or the work involves physical stress, but in most cases, patients return to work after 7 days.

Despite returning to your normal lifestyle in a short time after the intervention, rehabilitation lasts up to 6 weeks, which is associated with the healing of internal sutures, so during this period it is important to follow some rules:

1. The first month shows abstinence from sexual activity and heavy physical labor;
2. It is allowed to resume sports activities no earlier than a month after laparoscopy, starting with a minimum load and gradually increasing it;
3. For the first 3 months you are allowed to lift no more than three kilograms;
4. Compliance with the diet in the first 2-3 weeks;
5. It is better to replace a sauna or hot bath with a shower, and you can go to the pool after 4-6 weeks.

In order not to provoke suture divergence, it is important to lead a gentle lifestyle. You shouldn’t grab hard work, even if it consists of the usual household chores, run to the gym, or pick up babies. It is good if close relatives take on some responsibilities during the rehabilitation period.

Diet is very important. Food should not be heavy and difficult to digest; for the first 2-3 weeks it is better to give up salty, spicy foods, smoked foods and alcohol in favor of fermented milk products, lean meat and fish, and cereals.

An important issue is the possibility of pregnancy after ovarian laparoscopy, especially considering that most patients with cysts are young women of reproductive age, and in case of polycystic disease, the operation is precisely aimed at ensuring ovulation.

The menstrual cycle is restored in the first 2-3 months, but more often the first menstruation after the intervention occurs without delay on time. It is better to plan pregnancy 3-6 months after treatment.

Laparoscopy of the ovaries significantly increases the chance of pregnancy in women with polycystic disease, and pregnancy can occur after just a couple of months. If difficulties arise with conceiving after the intervention for a year, then experts will recommend in vitro fertilization.

Laparoscopy of the ovaries is considered a safe operation, but still completely excludes the possibility complications it is forbidden. The most likely of them are:

• Allergic reactions to anesthetic drugs;
• Damage to internal organs by trocars and instruments;
• Bleeding due to insufficient hemostasis;
• Adhesive process;
• Entry of air under the skin due to pneumoperitoneum;
• Chronic pelvic pain;
• Inflammation or suppuration of cuts or punctures;
• Postoperative hernias.

It is worth noting that Complications after ovarian laparoscopy are very rare and account for no more than 2% of cases. If the woman was carefully prepared for treatment, and the operation was performed by an experienced, highly qualified specialist, then the risk of complications is minimal.

Patients who are about to undergo surgery are very worried about whether it will hurt, whether pregnancy will occur later, etc., so they seek to find out reviews from those who have already undergone treatment. In the vast majority of cases, the reviews are positive, since the postoperative period passes easily and quickly, without bringing negative emotions, and after a short period of time the desired pregnancy can occur.

Laparoscopy of the ovaries can be performed free of charge - according to indications, in a public clinic, in the order of priority for patients. Treatment on a paid basis is possible, but the price for laparoscopy will be higher than for laparotomy surgery. The cost of ovarian laparoscopy varies depending on the complexity of the operation, ranging from 20 to 50 or more thousand rubles.

Content

Removal of a problematic ovarian cyst is a common gynecological operation. The method helps a woman improve her health and subsequently have a chance to get pregnant. It is important to take care during the postoperative period and take into account the doctors’ explanations. Following a regimen and diet will lead to recovery in a short period.

Rehabilitation after laparoscopy of ovarian cyst

The situation when, during ovulation, the egg was unable to leave the ovary, causes the accumulation of fluid, the appearance of a cavity - a cyst. The neoplasm can be located outside or inside, causing suppuration, hemorrhage, or rupture. The operation to remove an ovarian cyst is performed using a gentle laparoscopic method, leaving small stitches afterwards. Under general anesthesia, three small incisions are made in the anterior wall of the abdomen: the camera and instruments are passed through them. For ease of access to the surgical site, a special gas is pumped into the peritoneal cavity.

Recovery after laparoscopy of an ovarian cyst occurs much faster than with abdominal interventions. To avoid complications and to carry out the process actively, it is recommended:

• maintain dietary nutrition;
• exercise moderately;
• take vitamins;
• adhere to the recommendations of gynecologists;
• do physical therapy.

What can you eat

It is not advisable to eat food on the day of surgery, and on the next day: drink only water, and that without gas. Next, to restore intestinal function, you need to eat pureed or steamed food. It’s good to eat soups, cereals, and bananas at this time. After a month, you can remove all restrictions. The diet after laparoscopy involves excluding for a while:

• fresh vegetables, fruits - the first week;
• flour food;
• smoked meats;
• salty, spicy.

What discharge is considered normal?

During the recovery stage after laparoscopy of ovarian cysts, patients may experience discharge. The first days they are bloody, a small amount is considered normal. Over the next two weeks, clear mucus may appear. Sometimes there is scanty bleeding. You should be concerned and consult a doctor if:

• heavy bleeding;
• discharge is whitish, yellowish in color.

What to do if your stomach hurts

Pain often accompanies recovery. They are localized in the area of ​​the sutures, the middle part of the abdomen, and last for several days - up to a week. To reduce it, it is recommended to take painkillers, not make sudden movements, and rest. Due to the filling of the peritoneum with gas during surgery, pressure occurs on the diaphragm. This causes pain in the muscles of the body, aches in the back and neck. To cope with them, you need to actively move and walk. Medicines are useless in such a situation.

On what day are stitches removed?

When laparoscopic surgery is performed, the patient can get up within 3 hours. It is recommended to start moving immediately, but everything should happen smoothly. The seams must be treated every day for a week with disinfectants, and drainage should be carried out if necessary. They heal completely in about eight days. A woman often starts work at this time, but must come to the hospital to have her stitches removed. Scars after laparoscopic surgery become invisible very quickly. This is how they look in the photo when they were discharged from the hospital - two at the bottom, and the third in the navel.

How long to stay in the hospital

If the laparoscopic operation was successful, without complications, the patient is discharged on the third day. More often this happens on the fifth day, and then the sick leave is extended until ten. During this period, treatment ends and recovery of the body begins after laparoscopy of an ovarian cyst. To ensure more active recovery upon discharge from the hospital, it is advisable to adhere to the following recommendations:

• You can’t take a bath or wash in a sauna for a month;
• sex after laparoscopy is allowed only after 4 weeks (early pregnancy is not encouraged);
• limit physical activity for 30 days;
• do not travel during this period;
• no heavy lifting for 3 months;
• take water procedures in the shower.

When does your period start?

If the cyst is successfully removed, menstruation begins on time, which increases the chances of getting pregnant. This does not always happen, everything is very individual. Feedback from patients shows that two cycles may be missed. If the delay is longer, you should visit a specialist. There is a possibility of changes in the duration and nature of menstruation - this is normal, there is no need to worry. Heavy and prolonged menstruation poses a danger.

Possible complications

As with any intervention in the body, this gynecological operation has its own peculiarities. For a young body, recovery often occurs in a very short time. Older women may have complications as a result of the operation: this is due to the developmental characteristics and size of the cyst, problems during surgery, and the presence of chronic diseases in the patient (polycystic disease).

During the operation, it is possible that a situation may arise where the entire ovary will need to be removed: this can have an unpleasant consequence - infertility. Since laparoscopy uses anesthesia, nausea, dizziness, and vomiting are observed after the procedure. When patients violate the doctor’s instructions, move little, skip physical procedures, the formation of postoperative adhesions is possible.

When performing laparoscopic intervention there is a possibility of undesirable consequences:

• heavy bleeding;
• injury to neighboring tissues and organs due to poor visibility;
• dissection of nearby vessels;
• allergy to gas, anesthesia;
• elevated temperature after laparoscopy;
• infectious diseases due to weakness and vulnerability of the body.

When can you plan a pregnancy after laparoscopy?

It is advisable to implement your plans to become pregnant six months after laparoscopic surgery, when the body has recovered. It is necessary to take some measures to guarantee pregnancy:

• drink folic acid for three months;
• both partners should stop smoking and drinking alcohol;
• avoid stress;
• eat healthy food with vitamins;
• move a lot;
• see a gynecologist;
• get tested;
• exclude sexually transmitted infections;
• be examined by ultrasound;
• undergo genetic counseling;
• plan conception on the days of ovulation.

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In any case, open surgery is a trauma for the human body. Tissue trauma is accompanied by a number of negative reactions of the whole organism. After all, in essence, the body is an integral system, which, like any other closed system, does not tolerate interference (let alone destructive) from the outside and reacts sharply to it. If a patient's medical history includes surgery, most medical specialists try to avoid repeat surgery and prescribe it in the most extreme cases when other treatment methods have not had a positive effect. At the same time, in the modern medical world, laparoscopy is considered the most painless and least traumatic operation, as it requires minimal surgical intervention. Therefore, laparoscopy of an ovarian cyst after surgery is one of the most gentle ways to solve the problem of removal. It is obvious that the less stress we put on the body during treatment, the more it is inclined to cope with the disease itself. It is believed that if the patient has undergone a preliminary open operation, then laparoscopy of an ovarian cyst after surgery is the most loyal and simple way to remove the cyst.

Preparation for laparoscopy of ovarian cyst

Preparation for laparoscopy of an ovarian cyst is as follows: first of all, you need to get tested. All necessary tests are prescribed and prescribed by the attending physician. As a rule, these are urine tests and blood tests for coagulation, as well as an analysis to determine glucose levels, in addition, blood tests for the presence of AIDS, hepatitis and infectious diseases are mandatory. Immediately before surgery, a thorough examination of all pelvic organs, chest organs and an electrocardiogram is performed. In the evening before the day of surgery and directly on the day of surgery, mandatory enemas are given, and it is also recommended to use laxatives at this time. You should limit your intake of water and food on the eve of laparoscopy. The last meal is allowed the evening before the day of surgery, but no later than 19:00. The last intake of water is possible at 22:00, the evening before the day of surgery. Later, you are prohibited from eating or drinking any liquid until the operation itself. Directly on the day of the operation, you need to consult with an anesthesiologist about the characteristics of your body, if any, regarding the upcoming anesthesia. It is also important to remember that the pubic area should be shaved at the time of surgery.

Tests before laparoscopy of ovarian cysts

Before the operation of laparoscopy of an ovarian cyst, you must first undergo a series of tests, the results of which will help the attending physician perform the operation as safely and painlessly as possible. Mandatory tests before laparoscopy of an ovarian cyst:

• general blood and urine analysis;
• blood test to determine blood group and Rh factor;
• electrocardiogram and fluorography;
• biochemical blood test to determine the level of glucose, total protein, bilirubin;
• blood test to test for the presence of HIV, hepatitis groups B and C, syphilis;
• vaginal smear to determine microflora;
• hemostasiogram to determine the degree of blood clotting.

All tests before laparoscopy of an ovarian cyst are prescribed by the attending physician, who can also provide additional advice on the appropriateness of the tests and explain the significance of each for a correctly performed operation.

How is laparoscopy of an ovarian cyst performed?

After the patient passes all the preliminary examinations and the test results come back, the operation itself follows. Before surgery, many are concerned about the question of how ovarian laparoscopy is performed. This operation is quite simple; fear and concerns about laparoscopy are often unnecessary and not justified. The patient is taken to the operating room on a special gurney, where she is helped onto the operating table. Next, an intravenous catheter is installed to supply all the necessary medications to the body. After the anesthesia has taken effect and the patient falls asleep, the abdomen and perineum are lubricated with a special disinfectant solution and a urinary catheter is placed if there is a need for it. The abdominal cavity is filled with gas, the operating doctor makes several punctures through which the instruments necessary for the operation and a video camera are inserted, which displays the image on the screen. The surgeon sees the internal organs on the screen and conducts the operation using the image from the monitor. Using instruments, the cyst is removed without affecting healthy ovarian tissue. Next, the gas is released from the abdominal cavity using a special device, and a suture and sterile bandage are applied to the injured tissue. In some cases, after removal of the cyst, a silicone drainage tube may be left in place for a day, which the doctor will definitely inform the patient about after laparoscopy.

How long does laparoscopy for an ovarian cyst take?

Laparoscopy is an “elegant” operation, very precise and requiring the utmost attention of the surgeon, as it is performed under high magnification and with extreme caution to minimize trauma to healthy tissue and blood loss. However, laparoscopy is considered the most painless and simplest method of surgery. It is impossible to answer the question of how long laparoscopy of an ovarian cyst lasts. Since it depends on the severity of the disease and the individual characteristics of the patient. On average, laparoscopy operations can take from 15 minutes to an hour. With all the preparations, administration of anesthesia and recovery from the state of anesthesia, the operation in general can take a maximum of three hours. The duration of the operation also directly depends on the qualifications of the doctor who performs it. On average, in patients with moderate pathology, laparoscopy of an ovarian cyst itself lasts about 40 minutes. The laparoscopy method today is considered the most painless, gentle and safe compared to other existing operating methods.

Laparoscopy of endometrioid ovarian cyst

An endometriotic cyst forms on the surface of the ovary or inside it and is a cavity bounded by walls of varying thickness, filled with thick contents. A dangerous feature of such a cyst is damage to its walls during menstruation, which leads to fluid entering the abdominal cavity. In most cases, the occurrence of an endometriotic ovarian cyst occurs unnoticed by the woman and ends in reproductive dysfunction and infertility. Currently, surgical intervention for this disease is a direct indication for treatment, which is due to the ineffectiveness of other treatment methods, as well as the exclusion of the possibility of oncological formations. The most common method of treating this pathology is laparoscopy of endometrioid ovarian cyst. Endometrioid ovarian cysts are usually bilateral and increase in size quite quickly. Laparoscopy of an endometrioid ovarian cyst performed at an early stage of the disease is the safest and guarantees a high percentage of a favorable course of the postoperative period without complications and significant changes in the woman’s body.

Laparoscopy of paraovarian cyst

A paraovarian cyst is a tumor-like formation that forms from the ovarian epididymis. This disease can be completely asymptomatic or with clearly defined characteristic symptoms. The danger of this pathology lies in the fact that, unlike some other types of ovarian cysts, a paraovary cyst never resolves on its own and cannot disappear during any self-treatment; the formation must be surgically removed. The most common method of removal is laparoscopy of a paraovarian cyst. The condition of patients after laparoscopy of a paraovarian cyst is good, the reproductive system quickly returns to normal, and in the vast majority of cases no re-formations are observed. When deciding on the need for surgical intervention, the doctor focuses on a number of indicators of the patient’s condition, such as the overall size of the cyst, the dynamics of its growth, and the presence of discomfort. Possibility of negative consequences of surgical intervention (if the cyst is very large or there are concomitant pathologies of the pelvic organs).

Laparoscopy of dermoid cyst

An ovarian dermoid cyst is a benign formation on the body of the ovary, consisting of various tissues present in the human body, which are located in a jelly-like liquid and are located in a fairly dense capsule. A dermoid cyst may consist of nerve tissue, fat, bone tissue, hair, teeth, or skin. Most often, this cyst is discovered after it reaches a certain size and begins to injure neighboring organs, causing a lot of discomfort to the woman. The dermoid cyst is constantly increasing in size, so removal surgery is recommended as early as possible. There is the easiest, painless and effective removal operation - laparoscopy of a dermoid cyst. After such operations, the occurrence of relapses of the disease is minimized, at the same time, laparoscopy of a dermoid cyst is the most gentle treatment method for a woman’s body.

Laparoscopy of ovarian cyst during pregnancy

Pregnancy is one of the most important periods in a woman’s life, so at this time many women begin to monitor their health more carefully. The diagnosis of an “ovarian cyst” during pregnancy terrifies many women. But in reality, this diagnosis is not as scary as it seems. Naturally, an ovarian cyst can pose a serious danger to both the mother and her unborn child. Large cysts can provoke a miscarriage or the need for an abortion in late pregnancy; in addition, the fetus, increasing in size, puts pressure on the body of the cyst, which can cause it to rupture, which is extremely dangerous for the woman. Pathological changes in a woman’s body can be accompanied by discomfort, but they can also pass completely unnoticed, without any symptoms. Therefore, during pregnancy you should be carefully examined for the presence of ovarian cysts.

If there is still a cyst, then today’s surgical methods make it possible to remove it with minimal risk to the body of the mother and child. Laparoscopy of an ovarian cyst during pregnancy is a safe and gentle treatment method. Laparoscopy of an ovarian cyst during pregnancy allows you to minimize external intervention in the body and remove the cyst, with the least impact on healthy pelvic organs and the fetus itself.

Laparoscopy of ovarian cyst: contraindications

Despite the fact that laparoscopy of an ovarian cyst is considered one of the simplest and most painless operations to remove a cyst, there are still contraindications for this operation. Such operations are contraindicated for people who have suffered from infectious diseases within a month before the operation; laparoscopy of ovarian cysts is also contraindicated for people suffering from disorders of the cardiovascular and respiratory systems. Thus, bronchial asthma during an exacerbation is a direct contraindication for this operation. Patients with high blood pressure are also at risk, and laparoscopy in such patients can only be performed with the permission of the doctor, after test results and a thorough examination of the medical history. For laparoscopy of ovarian cysts, contraindications may include problems with blood clotting (a special blood test is performed before the operation to determine the level of clotting), or a hernia in the anterior abdominal wall. There are relative contraindications for surgery, in the presence of which the attending physician decides whether laparoscopy is appropriate. These are a high degree of obesity, cervical cancer, large adhesions in the abdominal cavity or the presence of a large amount of blood in the abdominal area. Also a relative contraindication is the large size of pathological formations on the ovary and a malignant ovarian tumor.

Consequences after laparoscopy of an ovarian cyst

The postoperative period of laparoscopy, for the most part, is easy and painless for the patient. Usually, by the second postoperative week, ability to work and physical activity are fully restored. The consequences after laparoscopy of an ovarian cyst can be directly related to anesthesia, since in different people anesthesia causes completely different, often unpredictable, body reactions. The consequences of ovarian cysts after laparoscopy can also be expressed in adhesions, which, without treatment, can lead to infertility and the development of a number of gynecological diseases. Unfortunately, adhesions after any operation are a fairly common problem. If the postoperative regimen is not followed correctly, there is a risk of developing infectious processes in the body, since laparoscopy is still, although relatively easy, an operation that requires intervention in the body; the ovaries after laparoscopy are to some extent injured, which facilitates access and spread of infections. To minimize the negative consequences after laparoscopy of an ovarian cyst, it is necessary to regularly see a doctor for a year, follow all his instructions and take a restorative course of medication after surgery.

Complications after laparoscopy of ovarian cysts

Minor complications after laparoscopy of ovarian cysts occur in only two percent of one hundred cases. The list of minor complications includes postoperative symptoms such as nausea or vomiting, postoperative infection, which is accompanied by a significant increase in temperature, chills and fever. There may also be slight bleeding in the areas where the incisions were made. There are also a number of serious complications that are extremely rare and account for less than one percent. But, nevertheless, there is still a low probability of such complications. Serious complications after laparoscopy of ovarian cysts are mostly associated with the professionalism of the surgeon. Such complications include damage to healthy pelvic organs, damage to large important vessels such as the aorta or pudendal vein, and damage to the nerves of the pelvic area. In addition, there are a number of cases where complications are caused by severe allergic reactions to anesthesia and the body's reactions to carbon dioxide, a gas that is injected into the abdominal cavity during surgery.

Pain after laparoscopy of ovarian cyst

After laparoscopy of ovarian cysts, quite severe pain may occur in the places where the incisions were made. This should not cause unnecessary concern and suspicion, because this is the body’s natural reaction to surgery. If the pain is too strong and causes discomfort, you should consult with your doctor, who will prescribe the most effective pain reliever based on the individual characteristics of the particular patient. Also, pain after laparoscopy of ovarian cysts can be localized in different places in the abdomen, but, as a rule, such pain goes away after three to five days after the operation. If the pain continues much longer and is very disturbing, you should definitely consult a doctor, since such pain after laparoscopy of an ovarian cyst may indicate the occurrence of complications. You may also experience some mild shoulder pain after surgery because the gas that is injected into the abdomen during surgery may be an irritant to the phrenic nerve. In rare cases, pain after laparoscopy, ovarian cysts are caused by an infection that has formed at the incision sites. In these cases, antibiotics are used to treat the infection and relieve pain.

Temperature after laparoscopy of ovarian cyst

During the normal course of the postoperative period, the temperature after laparoscopy of an ovarian cyst in the first few days after surgery can rise to 37 degrees. This should not cause concern, since such an increase in temperature is a sign that the body is accumulating its strength to heal wounds and normalize the functioning of the reproductive system. In most cases, such an increase in temperature is not accompanied by any other negative symptoms, indicating that any bad processes are occurring in the body. However, if this temperature persists for more than ten days after surgery, you should consult a doctor to rule out the possibility of inflammation. A strong increase in temperature should be an alarming signal, since in the vast majority of cases such symptoms indicate possible complications. Thus, an infection that occurs at the sites of incisions or directly at the site of cyst removal can provoke a sharp and significant increase in temperature to 38 degrees and above.

Discharge after laparoscopy of ovarian cyst

After any surgical operation on the ovary, a shift in the menstrual cycle occurs, and discharge after laparoscopy of ovarian cysts can occur either immediately immediately after the operation or at any other postoperative period of time. This is considered normal and should not be a cause for any alarm. Such discharge is most often minor and mucous in nature and can persist for several weeks. Yellowish-green or brownish-green vaginal discharge is a sign that there is an infection in the body and should prompt immediate medical attention. Such discharge is often accompanied by characteristic symptoms, such as general weakness, drowsiness, high fever, nagging pain in the lower back, and discomfort in the genital mucosa. White discharge appears if laparoscopy of an ovarian cyst was performed while antibiotics were taken, and indicates that thrush has appeared. Such discharge may also be bloody. But these character discharges do not always indicate thrush. There are a number of cases when whitish discharge indicates the presence of other infections in a woman’s body, the nature of which can only be determined by passing a vaginal smear for analysis.

Pregnancy after laparoscopy of ovarian cyst

The laparoscopic method of removing pathological formations has opened up completely new opportunities in the field of medicine. During laparoscopy of an ovarian cyst, the ovary itself is not removed and, even in most cases, healthy organ tissue is not injured. Only the body of the cyst is removed, after which the ovary gradually restores and normalizes its functions. Pregnancy after laparoscopy of an ovarian cyst can occur either very soon or some time after the operation. This depends on the individual characteristics of the body and the cycles of functioning of the reproductive system under normal conditions. According to statistics, on average, the ovary takes up to three months to recover after removal of a cyst. Therefore, pregnancy may not occur in the next three months after the operation, but it is not desirable until the body has fully recovered. In addition, after laparoscopy of an ovarian cyst, you should abstain from sexual intercourse for at least a month to avoid the development of complications and infections, as well as to minimize trauma to the ovary. According to statistics, only five percent of women who underwent laparoscopy for ovarian cysts were unable to become pregnant within a year after the operation. In all other women, pregnancy after laparoscopy of an ovarian cyst occurred in the period from one month to six months after the operation. If a woman becomes pregnant in a short time after laparoscopy of an ovarian cyst, she needs to be under the supervision of a doctor who will eliminate the risk of developing pathologies in the fetus, and also prevent possible relapses of the disease in the expectant mother.

According to the rules of medical institutions, the patient remains in the hospital one day after laparoscopy of an ovarian cyst so that doctors can monitor her condition and adaptation. If no acute complications arise, the patient is sent home, where she must follow all recommendations after laparoscopy of the ovarian cyst regarding the postoperative regimen. It is necessary to refrain from sexual intercourse for a month to prevent trauma to the ovary, infection or suture dehiscence. For the first two weeks after the operation, it is forbidden to take a bath, and after all water procedures it is necessary to lubricate the stitches with disinfectants. In the first month after surgery, it is also forbidden to drink alcohol, eat too fatty or heavy foods, because this prevents the body from quickly coping with the adaptation period. The wound in the abdominal wall is very sensitive, so it is recommended to wear loose clothing to prevent squeezing organs and damaging the stitches. Bed rest is recommended for the first few days, but in subsequent days doctors advise being active, as this will speed up the end of the postoperative period.

Postoperative period after laparoscopy of ovarian cyst

Many women in the postoperative period after ovarian laparoscopy experience some emotional discomfort, expressed in anxiety, unreasonable fears, excessive tearfulness and sudden mood swings. The adaptation period after laparoscopy is much easier and faster than after strip surgery. However, the attending physician prescribes painkillers for the first time after surgery and antibiotics to avoid inflammation. If there is a need to remove sutures, they are removed on the seventh day after the operation. The first week you need to do a dressing, which includes changing a sterile bandage on postoperative wounds and lubricating the incision sites with an antiseptic. During laparoscopy of an ovarian cyst, the integrity of healthy tissue is not violated, and therefore menstrual function is not disrupted. Normally, the next menstruation after surgery should occur as scheduled. It is also recommended to reduce physical activity, in particular limiting weight lifting to three kilograms. In the postoperative period after laparoscopy of an ovarian cyst, it is recommended to eat small portions many times a day and exclude fatty and heavy foods, spicy and salty foods from the diet to normalize intestinal function.

Limitations after laparoscopy of ovarian cysts

As with any other operation, there are limitations after laparoscopy of an ovarian cyst. First of all, these are restrictions on sexual intercourse, since the first month after the operation, doctors recommend maintaining sexual rest. There are also restrictions on sports, physical activity and weight lifting. For those involved in any kind of sport, it is not recommended to resume training earlier than a month after surgery, and when restoring training, increase the load gradually, starting with the least. As for lifting weights, doctors do not recommend lifting more than three kilograms during the first three months after surgery and more than five kilograms during the next three months. After this period, you should see your doctor. If no complications arise within six months after the operation, the doctor will allow you to return to your usual lifestyle and normal activities. There are also some restrictions in the diet, since for the first time (approximately two to three weeks, depending on the patient’s condition), it is recommended to limit the consumption of too spicy and salty foods, as well as eliminate alcohol.

Rehabilitation after laparoscopy of ovarian cyst

Rehabilitation after laparoscopy of an ovarian cyst is much faster than after other types of operations and takes an order of magnitude less time, since there is no serious damage to the body tissues. From the very first day, patients can move independently and eat light food. Complete rehabilitation of orgasm occurs three to six months after surgery, depending on individual indicators. During the rehabilitation period, there must be dynamic medical observation of the patient; control ultrasound is carried out one month, three and six months after the operation, and then every six months. Rehabilitation after laparoscopy of an ovarian cyst most often proceeds without complications and with a minimal degree of discomfort.

Recovery after laparoscopy of an ovarian cyst

Recovery after laparoscopy of an ovarian cyst, if the doctor’s postoperative recommendations are followed, occurs quite quickly. As a rule, after two to three weeks, the ability to work is fully restored and the patient can go to work if necessary. The menstrual cycle in some individual cases may be out of rhythm, but this is not considered a pathology and, after some time, the rhythms even out and the amount of discharge stabilizes. Since laparoscopy of ovarian cysts is an organ-preserving type of operation, it has virtually no effect on future pregnancies and childbirth, or on the health and development of the fetus. Also, if a woman is of childbearing age, then in the period from three to six months after laparoscopy she is prescribed hormonal therapy to completely normalize the functioning of the ovaries and maintain adequate hormonal levels. After the surgical incisions heal, two or three small scars ranging in size from 5 to 10 millimeters remain on the woman’s body, which, with proper care in the postoperative period, become almost invisible over time.

Treatment after laparoscopy for ovarian cysts

Ovarian cysts may appear again after surgery. The probability of such cases is not very high, but it still exists. In addition, after laparoscopy, adhesions may begin in the body, which entail unpleasant consequences for the woman’s health. Therefore, in the vast majority of cases, doctors prescribe treatment after laparoscopy of an ovarian cyst. In order to prevent the recurrence of cystic formations, medications containing elements of male hormones are prescribed. Gonadotropin-releasing hormone agonists are also prescribed. The name of this drug looks scary and many women are afraid that drugs of this kind will lead to some complications in the functioning of the body. In fact, this drug was originally created as a drug to treat infertility. But later, scientists and doctors discovered some other positive benefits of these drugs. Also, treatment after laparoscopy of an ovarian cyst includes a course of antibiotics that prevent inflammatory processes in the operated areas. For more active recovery, doctors also prescribe vitamins and some herbal medications.

Nutrition after laparoscopy of ovarian cyst

Nutrition after surgery for laparoscopy of an ovarian cyst should be formed in such a way that it is as easy as possible for the body to rehabilitate after the operation. It is very important to eat foods containing fiber, since fiber has a beneficial effect on the condition of the intestines and blood glucose levels. After laparoscopy of an ovarian cyst, it is recommended to carefully monitor the condition of the intestines, since these organs are in close proximity to each other. For the same reason, doctors recommend that in the first month after surgery you refrain from eating fatty and difficult-to-digest foods, as well as those dishes that irritate the mucous membranes of the gastrointestinal tract, for example, too spicy or too salty dishes. Otherwise, you can stick to your usual diet, subject to the mandatory exclusion of alcohol for a month and a half after surgery.

Diet after laparoscopy of ovarian cyst

There is no specific diet in the medical meaning of this term after laparoscopy of an ovarian cyst. But in the usual understanding of this word, as restrictions in the usual diet, there are still some recommendations. The diet after laparoscopy of an ovarian cyst should be as gentle as possible for the body so that the reproductive system has the opportunity to quickly recover. Therefore, doctors advise not to overload the body with heavy foods, not to overeat and not to drink alcohol (in addition, a course of antibiotics will most likely be prescribed after laparoscopy, so alcohol is strictly excluded). The diet after laparoscopy of an ovarian cyst is very simple and consists of consuming healthy, light meals in small portions many times a day. It is also recommended to eat plenty of foods containing fiber and natural vitamins, which are found in fruits, vegetables and other plant-based foods. Cereal-containing products and freshly squeezed juices also have a good effect on the treatment process and wound healing.

Ovarian cysts are a common cause of lower abdominal pain and infertility. They come in different origins and structures, but a cyst of any type at a certain stage of its development may require surgical treatment. A modern gentle surgical method is laparoscopy of an ovarian cyst, which allows to shorten the length of hospitalization and speed up the patient’s postoperative recovery.

What is an ovarian cyst

A cyst is a round, hollow formation on the surface of the ovary or in its thickness, resembling a bubble. Its contents and wall structure depend on its origin. Although it is a benign tumor, some types of cysts can degenerate into cancerous cells. This process is called malignancy.

Sometimes a similar formation occurs in ovarian cancer, when, due to central disintegration, an uneven cavity is formed inside the tumor. During examination, women may also be diagnosed with paraovarian cysts. The fallopian tubes take part in their formation, but the ovarian tissue remains unchanged.

Possible types of ovarian cysts:

1. , which is formed from a follicle that did not rupture during the ovulatory period, streaks of blood are sometimes found in the fluid inside such a cyst;
2. , which occurs at the site of the ovulated follicle (in the corpus luteum), contains serous fluid and sometimes an admixture of blood from destroyed small vessels;
3. , which develops when endometrial cells multiply outside the lining of the uterus, undergoes cyclic changes in accordance with the menstrual cycle and contains a dark, thick liquid;
4. a dermoid cyst (or mature teratoma) may contain germinal tissue or even partially formed formations (teeth, hair), is formed at the site of an egg that has begun to develop independently and is often congenital;
5. mucinous - is multi-chambered and contains mucus, can grow up to 40 cm in diameter.

Follicular cysts can be multiple, in this case they speak of. In each cycle, the egg does not ovulate; the follicle continues to grow and turns into a cavity under the outer membrane of the ovary. Other types of cysts are usually solitary.

When does pathology require treatment?

Follicular and luteal cysts are hormonal-dependent and can gradually resolve. But if they reach large sizes and do not undergo reverse development, they must be removed. When endometrioid formations are detected, conservative therapy is first prescribed. If it is ineffective and there are large formations, a decision is made on surgery. All other types of cysts require only surgical treatment. In case of infertility, the doctor may recommend removing even small tumors, after which hormonal therapy is most often prescribed.

The purpose of the operation is to completely remove the pathological formation. In women of reproductive age, they try to preserve ovarian tissue as much as possible, performing only resection. And in postmenopause, when sex hormones are practically no longer produced, the entire organ can be removed without consequences for the woman’s health.

The operation is performed using the classical method (through an incision on the anterior abdominal wall) or laparoscopic removal of the ovarian cyst is performed. In both cases, the woman goes to the hospital, most often such hospitalization is planned.

Benefits of laparoscopy

Removal of an ovarian cyst by laparoscopy is a gentle intervention. All manipulations are performed through 3 punctures of the abdominal wall. In this case, the abdominal muscles are not dissected, the thin inner serous lining of the abdominal cavity (peritoneum) is minimally injured, and there is no need to manually move the internal organs away from the surgical site.

All this determines the main advantages of the laparoscopic method over classical surgery:

1. lower risk of development in the future;
2. low probability of a postoperative hernia, which may occur due to incompetence of the dissected muscles of the anterior abdominal wall;
3. small volume of surgical wounds, their rapid healing;
4. gentle effect on neighboring organs during surgery, which reduces the risk of postoperative intestinal hypotension;
5. fewer restrictions in the postoperative period, earlier discharge from the hospital;
6. no deforming postoperative scars; puncture marks can be hidden with underwear.

The laparoscopic treatment method allows a woman to quickly return to normal life, without being embarrassed by her appearance and without worrying about the possible development of long-term consequences after surgery.

Preparation

Before laparoscopic surgery to remove an ovarian cyst, a woman must undergo an examination, which is usually performed on an outpatient basis. It includes a general and biochemical blood test, urine test, blood collection for screening for hepatitis, syphilis and HIV, ultrasound of the pelvic organs, fluorography of the lungs, determination of blood group and Rh factor, and a vaginal smear for purity. In some cases, it may also be necessary to do an ECG, examine the state of the blood coagulation system, determine the hormonal status, and obtain a physician’s opinion on the absence of contraindications to surgery. The scope of research is determined by the doctor based on the overall clinical picture.

Before performing planned laparoscopy of an ovarian cyst, reliable methods of contraception are used. If you suspect pregnancy, you must inform your doctor in advance.

A few days before surgery, you need to exclude cabbage, legumes, carbonated drinks, brown bread and other foods that increase gas formation in the digestive tract from your diet. If you are predisposed to flatulence, the doctor may recommend taking sorbents and carminatives; cleansing the lower intestines is often prescribed. On the eve of the intervention, the last meal should be no later than 18:00, you can drink until 10:00 pm. On the day of the operation, it is forbidden to drink or eat; if you are very thirsty, you can rinse your mouth and moisten your lips with water.

Immediately before laparoscopy, pubic and perineal hair is shaved and a hygienic shower is taken. After this, you should not apply lotions, creams or other care products to the skin of the abdomen.

How is laparoscopy performed?

Laparoscopy for removal of an ovarian cyst is performed under general anesthesia (anesthesia). On the day of the operation, the woman is consulted by a resuscitator to identify possible contraindications and make a final decision on the type of anesthesia. Most often, tracheal intubation is used, which allows you to control breathing and maintain the required depth of immersion in anesthesia. Before this, premedication is carried out, when a sedative with a hypnotic effect is administered intravenously; tranquilizers are usually used for this. Instead of such an injection, you can use mask anesthesia.

The operating table is tilted with the head end down by 30º so that the intestine moves towards the diaphragm and opens access to the ovaries. After processing the surgical field, a puncture is made in the navel, through which the abdominal cavity is filled with carbon dioxide. This allows you to increase the distance between organs and creates space for the necessary manipulations. A laparoscope, a special instrument with a camera and a light source, is inserted into the same hole. It is advanced to the pelvis, where the ovaries are located. Under the control of a video camera, 2 more punctures are made in the lateral sections of the abdomen, closer to the groin, which are necessary for introducing manipulators with instruments.

After a thorough examination of the ovaries and cysts, a decision is made to continue laparoscopy or whether wide access to the abdominal cavity is necessary (which is quite rare). In the latter case, all instruments are removed and the classic operation begins.

During laparoscopy, the doctor can perform enucleation of the cyst, wedge-shaped resection (excision) of a fragment of the ovary with a cyst, or removal of the entire ovary. The extent of surgical intervention is determined by the type of cyst and the condition of the tissues surrounding it. At the end of the operation, a check is made for the absence of bleeding, the instruments are removed, and carbon dioxide is sucked out. External sutures and sterile dressings are applied to the puncture sites.

After removing the endotracheal tube, the anesthesiologist checks the patient’s breathing and her condition, and gives permission to transfer to the ward. In most cases, the patient does not need to be admitted to the intensive care unit, since vital organs are not disrupted and massive blood loss does not occur.

Postoperative period

After laparoscopy, getting out of bed early is recommended. After just a few hours, with stable blood pressure, it is advisable for the woman to sit down, stand up, and carefully move around the ward. A gentle diet is prescribed, including fermented milk products, stewed vegetables and meat, soups, fish, without products with gas-forming properties.

Sutures are treated daily and body temperature is monitored. Discharge is made 3-5 days after surgery, but sometimes already in the evening of the first day. Sutures are removed on an outpatient basis for 7-10 days. Full restoration of working capacity usually occurs by the 14th day, but if the woman is in good condition, the certificate of incapacity for work can be closed earlier.

Possibility of pregnancy

Until the end of the current menstrual cycle, it is advisable to exclude intimate contacts; if this recommendation is not followed, contraception must be used. Pregnancy after laparoscopy of an ovarian cyst can occur in the next cycle. Therefore, you should definitely check with your doctor when you can stop using contraception. With functional cysts (luteal and follicular) and polycystic ovary syndrome, conception is most often allowed after the first menstruation, if the operation and recovery period were without complications. But after removal of endometrioid cysts, a stage of drug treatment often follows.

Possible complications

The most common complication after laparoscopy of an ovarian cyst is pain. Moreover, unpleasant sensations are noted not in the area of ​​the operation or punctures, but in the area of ​​the right side and right shoulder. This is due to the accumulation of carbon dioxide residues near the liver, which irritates the phrenic nerve. Muscle pain and mild swelling of the lower extremities may also be noted.

In the first days after laparoscopy, subcutaneous emphysema may be observed, that is, an accumulation of gas in the upper layers of fatty tissue. This is a consequence of a violation of the surgical technique and does not pose any health hazard. Emphysema resolves on its own.

In the long-term postoperative period, adhesive disease occasionally develops, although the risk of its occurrence after laparoscopy is much lower than after classical surgery.

When laparoscopy is not performed

Despite the woman’s wishes, the doctor may refuse to perform laparoscopic surgery in the following cases:

1. severe obesity (grade 3-4);
2. detection of stroke or myocardial infarction, decompensation of existing chronic diseases;
3. severe disturbances of hemostasis due to blood coagulation pathology;
4. abdominal surgery less than 6 months ago;
5. suspicion of a malignant tumor (cyst) of the ovary;
6. diffuse peritonitis or severe hematoperitoneum (accumulation of blood and abdominal cavity);
7. the woman’s state of shock, increasing severe blood loss;
8. pronounced changes in the anterior abdominal wall with fistulas or purulent skin lesions.

Removal of an ovarian cyst laparoscopically is a modern and gentle method of surgical intervention. But the operation should take place after a preliminary thorough examination of the woman in the absence of contraindications to it. It must be remembered that some cysts can form again if predisposing factors are not eliminated. Therefore, in case of functional cysts, a dynamic study of hormonal status and correction of identified disorders are required.