What surgeries exist to remove an ovarian cyst. Surgery to remove an ovarian cyst - how it goes, how dangerous it is. Follow-up in the postoperative period

An ovarian cyst is a benign formation with liquid contents. Pathology is diagnosed in women of different ages. Cystic formation can be detected during a physical examination or upon presentation by the patient of complaints of pain in the lower abdomen, irregular monthly cycles and other complaints. If the neoplasm tends to grow steadily, it can reach a large size, which increases the risk of complications due to rupture of its capsule or twisting of the base. This is fraught with the development of conditions that threaten a woman's vital signs. In such situations, surgical treatment is indicated - removal of the ovarian cyst.

Should an ovarian cyst be removed? Neoplasms are of different types, some of them are not dangerous and tend to dissolve on their own. Therefore, the treatment of ovarian cysts can be conservative when it is carried out with hormonal agents.

But with an ovarian cyst, serious pathological changes can occur in its tissues.

If drug treatment has proven ineffective, specialists are considering the possibility of a surgical method for solving the problem in the following cases:

steady growth in the size of the cystic formation;
the presence of constant pain in a woman;
the slightest suspicion of malignant degeneration of cyst tissues;
risk of rupture of the cystic capsule and penetration of the contents into the peritoneal cavity;
twisting of the cyst base and further development of necrotic phenomena;
the presence of obstacles to the normal blood supply to the ovary due to the developed cyst;
formation pressure on nearby organs if a giant ovarian cyst has formed.

You can remove the cyst using different methods. They differ in the way they penetrate into the peritoneal region, the scale of manipulations due to the type of cyst, its size and localization. The specialists of the clinic should tell about how the operation to remove the ovarian cyst is performed, as well as agree on a number of points with the patient. In modern clinics, it is offered to watch videos of ovarian cyst removal operations in order to remove the unreasonable fear from patients that surgery is dangerous. It shows in detail all the stages, how the operation goes, how exactly the ovarian cyst is removed, what methods of removing the cyst are possible and how safe it is.

What are the methods for removing ovarian cysts and how to prepare for them

Methods for removing ovarian cysts are divided into 2 groups:

laparotomy of an ovarian cyst;
laparoscopic methods of surgical intervention.

If surgical treatment is unavoidable, preparation for surgery is an important step. A woman needs:

Undergo an additional examination for the absence of infectious inflammation in the pelvic area.
Take tests (blood, urine).
Follow a special diet during the week before the date of the operation. The diet includes avoiding heavy and fatty foods in order to reduce gas levels in the intestines.

Before the operation:

The last meal should be no later than 8 hours before the start of the operation.
Cleanse the large intestine with an enema or laxative the night before and again in the early morning on the day of surgery.

Laparotomy

What is it and how is this type of surgery performed? Laparotomy is a cavity operation to remove an ovarian cyst, which involves layer-by-layer dissection of tissues on the abdominal line, when resection of the cystic formation and other tissues or organs is performed, if necessary. In what cases is it carried out:

when the cystic capsule ruptures and its contents leak into the peritoneal cavity;
in the presence of a detected adhesive process;
in case of malignant degeneration of tissues;
due to the development of suppuration;
if the cyst is large.

With such penetration into the peritoneum, vast areas adjacent to the appendages are examined, the cyst is removed. If necessary, it is also necessary to cut out all the foci of endometrial lesions, excise adhesions, and remove a purulent infection.

The duration of the patient's stay in a hospital ranges from 5 to 7 days, she can return to the active mode in 1.5-2 months. Be sure to follow all medical recommendations in the postoperative period to avoid complications.

Laparotomy is performed in exceptional situations, since this is a rather traumatic surgical treatment that requires general anesthesia and a long process of the patient's recovery.

After the removal of the ovarian cyst, especially when the ovaries were removed along with the fallopian tubes during the operation, the patient is given a number of tips on maintaining a sparing regimen for a month, refusing sexual intercourse, limiting weight lifting, and taking hot baths.

If the surgeons did everything right, there were no complications, then there is no need to continue treatment. However, in some cases, if there is a suspicion of the possibility of a relapse, hormonal drugs, immunostimulants and vitamins, as well as physiotherapy procedures, are prescribed.

Laparoscopic methods

Such techniques are preferable to laparotomy, they allow operating with a low level of load on the body due to the use of local anesthesia, minimizing the risk of postoperative complications, reducing the patient's recovery period and returning her to an active lifestyle. The principles of preparation for laparoscopy are identical to laparotomy: diagnostics, tests, diet.

Laparoscopy is prescribed if:

the detected cyst is relatively small;
purulent lesions are not observed;
cystic formation formed as a small single structure or a group of small brushes is present (polycystic);
the cyst affected only the superficial ovarian tissues, which did not affect the change in the functions of the appendages.

The essence of laparoscopy is penetration into the peritoneal region through special punctures, and not a large incision. After 3-4 punctures, a mini-video camera with powerful optics and instruments are inserted, a special gas is pumped inside to raise the abdominal wall, improve visibility and increase the range of motion of the instruments.

Laparoscopy of an ovarian cyst

The entire process of the operation is displayed on the monitor. After penetration into the peritoneum, the surgeon evaluates the lesions of the ovarian and other tissues due to the growth of the cyst. Resection of cystic formation is carried out in stages and includes:

opening a cyst by puncturing its capsule;
extraction of cystic secretion (aspiration) using a special tool;
removal of empty capsule tissues.

After these manipulations, the peritoneal cavity is disinfected by the surgeon, gas is removed, a drainage system is installed, suture material is applied at the puncture sites and covered with bandages.

Laser technique

The laser method is similar to the general laparoscopy technique, but cyst resection is performed not with a scalpel, but with a special instrument using a laser beam. The doctor opens and exfoliates the cystic formation. Laser removal of the cyst can reduce the phenomenon of bleeding at the site of tissue excision, since the laser is able to immediately coagulate (cauterize) problem areas.

Removal of ovarian cysts with a laser is considered a more promising direction in a number of laparoscopic techniques.

Histology of an ovarian cyst is mandatory for any method of excision of a cystic formation.

Recovery period after laparoscopy

Due to the minimally invasiveness of laparoscopic techniques, the patient's recovery is much faster than with laparotomy. The sutures heal better, they are removed on the 6-7th day. In order to avoid the development of inflammation, antibiotic therapy is prescribed, with pain syndrome - painkillers. In order for the recovery to go without problems, the patient must follow all the recommendations of the doctors, and then she can return to her usual way of life in a couple of weeks. But you need to remember about the diet. The diet is shown not only before the operation, but also after it.

Duration of operations

Patients often ask the question: how long does the operation take? The amount of time required to perform all manipulations during surgery varies greatly. With laparoscopy, this time can be from half an hour to 1.5 hours; with laparotomy, the operation can take more than 2 hours. It all depends on the amount of necessary actions that the surgeon needs to perform.

In the case of removal of only a cystic formation (cystectomy), the duration of the operation is minimal. However, if there is a need to excise a part of the affected ovarian tissue, a larger resection (wedge-shaped) is performed, when a part of the ovary is cut out with a wedge in the place where the neoplasm has formed. In some situations, it is advisable to perform an oophorectomy when it is necessary to remove the neoplasm together with the ovary. Another, healthy ovary, not affected by pathological changes, will be able to continue to work fully. Such operations involve the preservation of the reproductive functions of a woman, if she is still planning a pregnancy. If the patient has crossed the threshold of menopause and there is a risk of malignant tissue degeneration, a more complex operation is performed to eliminate the neoplasm. It involves the elimination of the cyst itself, both ovaries, fallopian (uterine) tubes (adnexectomy). This process takes a lot of time and after such an operation, a woman needs more time to recover.

Situations stand apart when a cyst is found after removal of the uterus for various reasons (fibromyoma, myoma, malignant process on the neck). If the uterus was removed from women, then if it is necessary to remove the existing cyst, they try to perform the operation while preserving at least one ovary, since the functioning of this paired gonad is of great importance for hormonal balance, which ensures the patient's quality of life at the proper level. An ovarian cyst after removal of the uterus requires the most balanced and qualified approach to its treatment.

Prices

How much the treatment costs can be estimated approximately, because the cost depends on many factors, including the rank of the medical institution. The price of the operation is determined by the severity of the pathology, the volume of manipulations performed. To it are added the costs of diagnostics, carrying out the necessary tests, and the implementation of rehabilitation measures. On average, prices for the removal of ovarian cysts by laparoscopic techniques range from 15 to 40 thousand rubles. Laparotomy is more expensive and starts from 30 thousand rubles, but this method is not operated on so often.

Women who are faced with the problem of choosing a medical institution should take into account that the main criterion is, after all, not the cost of the operation, but the level of qualification of specialists performing operations to remove the ovarian cyst.

First of all, analyzes

The doctor will conduct a set of diagnostic studies that will provide all the necessary information about the patient's condition. In particular, it is necessary to do a urine and blood test (including biochemistry and blood coagulation tests), fluorography and an electrocardiogram.

Examining the results

The results of the research will be carefully studied by both the surgeon and the anesthesiologist, who will do everything necessary to ensure that the stay under anesthesia (and the operation is performed under general anesthesia) passes without consequences for the patient and does not last longer than the time required for the surgeon's manipulations.

moral preparation

The surgeon will tell the patient about the features of the upcoming operation, and the anesthesiologist - about the state of artificial "sleep" in which the woman will be immersed. Our doctors are not only competent specialists, but also excellent psychologists who know how to calm even the most anxious patient.

What about food?

Sister, scalpel! Getting Started with Laparoscopy

In fact, no scalpel is needed, and here's why.

Medicine of the XXI century: "massacre" is a thing of the past

Until recently, the operation to remove the cyst was performed only by the traditional abdominal method (it is called laparotomy). With it, a large incision is made through which the cyst is removed, and the recovery period is long and painful.

But Best Clinic specialists have been successfully practicing the modern endoscopic method - laparoscopy for several years. With this method, three tiny punctures are made on the abdominal wall, into which miniature instruments are inserted.

You are in the operating room. What do doctors do?

First, the anesthesiologist comes into action with his assistant - the Fabius Tiro apparatus. The patient smoothly plunges into a medical sleep, and the anesthesiologist carefully monitors her condition throughout the operation.

Then the surgeon injects a special gas into the patient's abdominal cavity, which expands the "field of activity" of the doctor and allows him to see the cyst in all details.

A laparoscope is inserted into the puncture of the abdominal wall - a probe with a miniature video camera. These are the "eyes" of the surgeon. The image from the video camera is transmitted to the screen.

The doctor will take a small part of the cystic tissue for analysis (it is necessary to exclude the malignancy of the neoplasm), and then begin to remove it.

Plasma comes into play

Best Clinic uses the innovative PLASMAJET plasma system to remove cysts and other neoplasms. It is a significant leap forward compared to the more familiar laser and electrocoagulation methods for removing cysts (there is no question of “classic” scalpels, as we said).

The plasma flow evaporates the tissues of the cyst without affecting the surrounding organs. This sparing method of exposure eliminates such unpleasant consequences of removing neoplasms using “traditional” methods, such as adhesions in the small pelvis.

Just a little bit left: the completion of the operation

After the ovarian cyst is finished, the surgeon, using the LigaSure apparatus, “solders” the damaged vessels. Thus, there will be no even minimal bleeding. All that remains for the doctor now is to close the punctures into which the instruments were inserted with a few stitches.

The total duration of the operation is about half an hour, after which the patient is transferred to another room, and the resuscitator proceeds to wake her up.

Recovery after cyst removal

The recovery process will not take long. Within a few hours after laparoscopy, the doctor will ask the patient to get up, and by the evening (if the intervention was performed in the morning), the woman will be able to walk. On the first day after the operation, it is necessary to take painkillers, then the discomfort practically disappears.

Usually the patient is discharged from the clinic on the second or third day, and she can return to normal life. A week later, the doctor will remove the stitches. Small scars left after punctures completely disappear in most of the operated patients within six months.

The doctor will continue to monitor the patient's condition and will prescribe her preventive examinations.

Pregnancy after laparoscopy: is it possible?

Yes, it is definitely possible. Often, it is the ovarian cyst that becomes an obstacle to pregnancy, and therefore, after its removal, the chances of becoming a mother increase significantly.

You only need to remember that experts do not recommend planning a pregnancy earlier than six months after the operation in order to exclude the possibility of a miscarriage. Listen to the advice of the gynecologist who is observing you: knowing everything about your condition, he will accurately determine whether the time has come to conceive a baby.

And do not forget that cystic formations must not only be removed on time, but also identified as soon as possible. Therefore, make an appointment at the Best Clinic and be sure that you are in good hands.

I decided to have an abdominal ultrasound. The reason was my disgusting condition for 4 months. In the evening, after eating, I felt bad, there was a heaviness in my stomach, I began to choke. Wild heartburn and stomach pains happened to me almost every month. Doctors treated my stomach, but I only got worse. An ultrasound showed that my stomach was healthy. Then the doctor suggested checking the pelvis. And on ultrasound of the small pelvis, a cyst of the left ovary was found, which was so large that it squeezed all neighboring organs.

I urgently went to the gynecologist, who confirmed my diagnosis and advised me to remove the cyst as soon as possible.

At first I was in a little shock, the operation, but I had never been in the hospital before. Then I started looking for information on the internet. Is it possible to somehow cure a cyst with pills. The gynecologist, of course, explained to me that such a large ovarian cyst only needed to be operated on, but my brain refused to believe it.

Resigned, I began to think in which hospital it would be better to operate. The ultrasound doctor advised me to go to the Russian Railways hospital, which I did. The head of the gynecological department listened to me, looked at me and we set an approximate date for the operation - laparoscopy.

Laparoscopy.

The doctor makes small incisions through which he inserts special microinstruments. The location of the incisions depends on the operated organ. For example, to remove a cyst, they are produced in the lower abdomen. The next step is to inflate the patient's abdomen with gas to move the instruments freely in the peritoneum. The preparation of the patient is completed, and the doctor proceeds to the operation. In addition to small incisions, the doctor makes one slightly larger incision through which the video camera will be inserted. Most often it is done in the navel (above or below). Once the camera is properly connected and all the tools have been entered, an enlarged image is displayed on the screen. The surgeon, focusing on him, carries out the necessary actions in the patient's body. It's hard to say right away how long such an operation takes. The duration can vary from 10 minutes to an hour.
After the operation, a drain is mandatory. This is a necessary procedure after laparoscopy, which is designed to remove postoperative blood residues, the contents of abscesses and wounds from the peritoneum to the outside. Installing a drain helps prevent possible peritonitis.
The operation is performed under general anesthesia. Before the introduction of sleeping pills, the anesthesiologist takes into account the age characteristics, height, weight and gender of the patient. After the anesthesia has worked, so that various sudden situations do not occur, the patient is connected to an artificial respiration device.

I was given a list of tests that need to be prepared for the operation.

The list was not small, everything that I circled had to be completed. Items from 1 to 8 took place in the district antenatal clinic. Items 12 and 14 gave me a referral to the antenatal clinic. The referral to the FGS was given to me by the local therapist, and on the basis of all the collected tests, the therapist wrote a conclusion and permission for the operation.

I already had a pelvic ultrasound and histology. It remains only to visit the vascular surgeon, who took me to another hospital and the appointment with him cost me 750 rubles. The surgeon looked at my legs and said that everything was fine, but for the operation you need to buy compression medical stockings that you need to put on before the operation in order to avoid the formation of venous thrombosis and pulmonary embolism.

All analyzes must be no later than 10 days old, points 5 and 8 - 3 months.

Having collected all the tests and the conclusion that the gynecologist writes and the therapist signs, I called the manager and she finally set the date for the operation - Tuesday.

On Monday morning, after collecting my things, I arrived at the hospital. I paid for the room for a week, it cost me 4800 rubles. The ward was double, with a toilet and a refrigerator. I dined in the hospital, but I was forbidden to have dinner. Before going to bed, I was given an enema and a sedative shot.

The next day, at 7 am, I was awakened and told to put on medical compression stockings without getting out of bed. I was not allowed to have breakfast or drink, and again they took me for an enema. Around 10 am, they began to prepare me for the operation. They invited me to a small operating room, where they inserted a urinary catheter. And I'll tell you this, it was the most unpleasant of all the procedures that they did to me, my thought at that moment was to get up and leave and I didn't care about any operations there. But having gathered all my will into a fist, because so much has already been passed, it remains to be patient a little and you are healthy, I got ready. They put me on a gurney and took me to the operating room.

In the operating room, they put a hat on me, inserted an IV infusion system into my arm, put a cuff on my other arm, which measured the pressure. Treated the abdomen with an alcohol solution. They hooked up an oxygen mask and began to inject anesthesia. After a couple of minutes, I passed out. Under general anesthesia, I had some dreams that I don't remember.

I woke up from a sharp jolt in the abdomen. I was taken to the intensive care unit, where everyone is placed for a day after the operation. They warmed me up and brought me to my senses. It was a little hard to breathe, mucus accumulated in my throat, but after I drank, everything went away. An hour later, I was already drinking myself, but it was impossible to eat. I was constantly put on drips, they gave injections a couple of times. They brought me a phone to the intensive care unit, I was able to call my husband and parents and calm everyone down.

In bed, I began to move a little, but it was still hard to roll over. Many write that after laparoscopy, the ribs and shoulders hurt from the air that is injected during the operation, but I didn’t have any pain at all, it was warm and calm. Periodically, I fell into a dream and woke up again, I can only sleep soundly at home.

The next morning, I was transferred to the ward, the urinary catheter was removed, the sutures were processed, and a drip was placed. On the left, at the site of the incision, I had a drainage from which a little pinkish water flowed. It's not scary, but a little uncomfortable, the nightgown was constantly getting dirty.

Little by little, I began to get up, made my way to the toilet, which, fortunately, was in the ward, and even managed to wash my hair in the sink. I was alone in the ward, my neighbor, with whom I spent the first day in the hospital, was discharged while I was in intensive care.

I was fed for another day with special postoperative food: liquid porridge, meat broth, and then they allowed me to eat normally. But to be honest, I didn’t have much appetite, although the food in the hospital was very tasty and satisfying, and I had yogurts and bananas in the refrigerator.

I had the operation on Tuesday, and on Friday the drainage was removed. The incisions were sealed with special sterile plasters, they did not hurt at all, but it was still difficult for me to walk.

On Saturday morning I was allowed to go home for the weekend, and on Monday morning I went to the hospital to get tested and have my stitches removed. After the stitches were removed, they gave me an extract, where they indicated what and how was carried out during the treatment.

They prescribed me a reception of "Vizzana", which I drank exactly one package, I was not enough for more.

Two weeks later, I came for a histological examination of the removed cyst of the left ovary.

A month after the operation, I went for an ultrasound. The left ovary was small.

Half a year after the operation, my ovary is still the same small, the gynecologist made a conclusion to me: dysfunction of the left ovary. They did not prescribe any medicines, they offered to drink the Inofert dietary supplement, after taking which there was no result. I think that in principle it could not be drunk.

Now there are a lot of women diagnosed with an ovarian cyst, or even two, my gynecologist told me about this, with whom I am now being observed. When I asked why so many people have this sore, she answers ecology and products.

The operation went smoothly for me, although with such a large ovarian cyst, the doctors in the operating room were ready for anything.

I hope my review will be useful to those who, like me, have been diagnosed with an ovarian cyst. After all, the first thing I went to was for reviews, because I was scared and did not know what was ahead of me. I didn’t take photos of the places of incisions and scars now, so as not to frighten the especially impressionable.

I wish you all good health and a good doctor, and if you do not trust one doctor, visit several more. After all, it will always be useful to double-check the diagnosis, especially when it comes to women's health.

It's been 14 months since my surgery and I decided to update my review.

Exactly one year later, the work of the left, treated, ovary returned to normal. Of the drugs for the last month, I took only the Cyclavit vitamins, which the gynecologist advised me. After the receptions of which, I had a double impression. Rather, I drank them like that, for prevention. I didn’t see any benefit from them, but I got fat.

In general, as I suppose, the ovary, a year after the operation, began to function normally by itself, it was only necessary to wait. Neither "Inofert" nor "Cyclovit" had any effect on his work, either for the worse or for the better.

An ovarian cyst is a benign non-tumor formation that requires surgical treatment. The most effective method of surgical intervention in this case will be laparoscopy - a delicate operation, accompanied by minimal trauma to the abdominal cavity and allowing not to affect the functionality of the ovary.

Laparoscopy is used to treat follicular neoplasms of the corpus luteum. In the vast majority of cases, doctors manage to save the organ and not affect its functionality: after removing the cyst, women retain the ability to conceive and bear a fetus.

Indications

One of the most common diseases of modern gynecology - an endometrioid ovarian cyst (a hollow formation ranging in size from 1.5 to 10 cm, inside which there is an old, coagulated brown blood) - requires medical diagnosis and surgical treatment. Accordingly, the sooner a woman turns to a specialist, the less damage to the body, in particular, reproductive function, will be caused.

It is planned to be examined by a specialist for women with a genetic predisposition to follicular formations. The cyst begins its development when menstrual blood enters the uterine pelvic cavity through the tubes: the cells of the inner surface of the uterus (endometrium) attach to various organs, including the ovaries, where they develop under the influence of progesterone and estrogen, causing regular inflammatory processes. Biochemical processes occurring during inflammation often lead to infertility.

Testing may be needed if you have the following symptoms:

pelvic pain before and during menstruation;
significant discomfort during intercourse;
pain when urinating.

Since the disease is often asymptomatic, and the cyst may not bother you for many years, a scheduled examination by a gynecologist will help eliminate the risk of its development.

In most cases, the ovarian cyst is removed in a planned manner, however, endometrioid and other formations in the corpus luteum have a risk of rupture of the cyst capsule or malnutrition. In the presence of such factors, the operation is prescribed on an emergency basis and may be accompanied by the removal of the appendage (pipe and ovary from the affected side).

List of diseases

Removal of an ovarian cyst is effective in the fight against the following diseases:

formation in the ovary (follicular, tumor), not amenable to regression within three months (on its own or under the influence of hormonal agents);
formations that appeared during menopause;
"twisted" leg of the cyst; rupture of the follicle, suppuration, hemorrhage;
suspicion of malignancy in the tissues of the ovary.

Training

Before an operation to remove an ovarian cyst is scheduled, a gynecologist performs a diagnosis, which includes the following steps:

collection of anamnesis;
manual inspection;
Ultrasound of the pelvic organs, carried out in at least two menstrual cycles;
colposcopy;
fluorography;
flora research;
blood tests - biochemical, clinical, histological (ROMA index, CA-125), to determine the Rh factor, blood group and coagulation, for HIV and RW;
MRI of the pelvic organs (may be required for a more accurate diagnosis).

One of the contraindications to laparoscopy may be overweight, therefore, before the operation, the doctor may prescribe a special diet and a set of exercises to normalize the body mass index.

Immediately before the operation, you must take a bath, remove hair from the abdomen and external genitalia. The last meal - until 19:00, drinking - at 22:00. Before the operation, it is necessary to clean the intestines with an enema - this will greatly simplify the surgical intervention, increase the range of instruments for laparoscopy and the radius of view.

How is the procedure

diagnostic laparoscopy (to confirm the diagnosis);
therapeutic laparoscopy (to eliminate the cyst);
control laparoscopy (to check the condition of the organ after treatment).

Laparoscopy of a cyst with preservation of the ovary:

the operation is performed under general anesthesia;
for greater convenience, carbon dioxide is injected into the abdominal cavity, which raises the wall in such a way as to open the doctor to a maximum view of the organs;
during laparoscopy, small incisions are made on the skin of the abdomen (anterior abdominal wall), not more than 1.5 cm in size (up to 4 incisions);
through them, trocars are inserted into the walls of the cavity to install the camera and instruments;
the cyst follicle is isolated within healthy tissues, producing a thorough hemostasis of the formation bed, then several internal sutures subject to resorption are applied to the cyst site;
the cyst is placed in a plastic container and removed through one of the incisions, then transferred to the laboratory for histological examination.

Ovarian resection

If a tumor, polycystic or cancer is found on the ovary, an ovarian resection is prescribed. The operation is prescribed only as a last resort, and often doctors try to use minimally invasive methods to treat ovarian cysts.

Postoperative period

On the first day after the operation, the doctor prescribes painkillers. If necessary, the doctor may additionally prescribe a course of antibiotics. Getting out of bed is allowed 3-5 hours after laparoscopy. Discharge from the hospital occurs within two days in the absence of complications. Removal of sutures is scheduled 6-7 days after the operation. Before the start of the next menstruation, a woman is not recommended to lift weights, experience significant physical exertion and have sex. The scars from the operation disappear in a short time and become invisible. During the first day after recovery from anesthesia, patients may experience pain, which is relieved by anesthetics.

Food

After laparoscopy, the doctor may prescribe a special diet that excludes alcoholic beverages and junk food. In the first days after surgery, experts recommend eating broths, sour-milk products, cereals, up to 1.5 liters of water per day and adhering to fractional nutrition (eat food in small portions, dividing it into 5-6 meals).

Possible Complications

The following symptoms may indicate an infection:

increased body temperature;
lower abdominal pain;
dark highlights.

Most often, complications occur due to factors:

obesity;
taking certain types of medications;
alcohol and tobacco use;
pregnancy.

At the first symptoms of malaise after the operation, it is necessary to immediately consult a doctor for an ultrasound scan and a detailed diagnosis, the results of which will prescribe a second treatment.

Pregnancy after laparoscopy

Many women worry about the possibility of pregnancy after laparoscopy. Modern technologies of minimally invasive surgical treatment allow maintaining reproductive ability even after removal of a large formation.

A woman should plan to conceive no earlier than 2-6 months after the operation. It is also necessary to regularly visit the attending physician to monitor the condition. It is possible to observe in a hospital for a detailed examination. To maintain health and prevent the recurrence of formations in the ovary, the doctor may prescribe medication aimed at balancing the hormonal background.

In the postoperative period, pregnancy may not occur due to the preservation of the focus of the disease. In this situation, a second laparoscopy is prescribed to finally remove the cyst and complete the treatment.

Surgical removal of an ovarian cyst is the most effective way to solve the problem, because medications in this case are most often powerless. Conservative treatment is ineffective or gives only a temporary result. The operation allows you to remove the formation, preserving the reproductive function, as well as avoiding the risk of developing malignant cells.

Indications for surgical treatment

The appearance of education is accompanied by unpleasant symptoms, and also affects the work of other internal organs - it is displayed on their functioning.

Indications for surgery to remove an ovarian cyst:

pronounced pain syndrome;
the rapid increase of the cyst to a size of more than 10 cm;
strong squeezing of blood vessels and internal organs, affecting their work;
hormonal therapy was not effective.

With a tried and failed conservative treatment, there is only one way to solve the problem - surgery.

There are several types of surgical intervention and all of them have their own characteristics; a specialist can choose the best method in a particular situation, based on the results of the tests and diagnostic studies.

Preparing for the operation

It is the preparation that determines the effectiveness of treatment, the correct choice of technique and the speed of recovery after surgery.

Proper preparation includes:

Weight normalization. Reducing the amount of body fat will improve access to the desired location, allow for the necessary manipulations and reduce recovery time after manipulation. To achieve weight loss, a diet and sports activities are necessary (physical activity is gentle, discomfort and pain in the ovary after exercise is unacceptable).
It is recommended to take sorbents daily for 5 days before the operation (if the manipulation is planned).
Eating mostly liquid meals 3-4 days before surgery, exclude foods that provoke bloating from the diet.
Bowel cleansing (enema).
Depilation.

In addition to general preparatory measures, medical research is also carried out. Preparatory activities:

blood test - biochemical, clinical;
urinalysis - clinical;
blood clotting test;
gynecological ultrasound;
analysis for HIV, STDs.

After the manipulations at the preparation stage, you can proceed to surgical intervention - removal of the ovarian cyst.

removal techniques. General characteristics

There are several methods for removing an ovarian cyst. The main differences are the method of penetration to the formation (laparoscopy or abdominal surgery) and the amount of tissue removed (only a cyst, a formation with a part of the ovary, excision of the ovary completely). The choice of technique depends on many factors, consider the features of each operation as a whole.

Removal methods:

Laparoscopic removal of an ovarian cyst is a minimally invasive intervention that does not require opening the abdominal cavity, but is carried out through small holes using a laparoscope. It has the shortest recovery period and minimal risk of complications.
Hollow operation. It is used in situations where a good overview is needed, or the contents of the formation have entered the peritoneum (violation of the integrity of the cyst), bleeding has opened.

Methods for removing a cyst:

Cystectomy - removal of a cyst without trauma to the ovary. It is carried out both laparoscopically and abdominal methods. The reproductive function is preserved, the ovary is restored after the operation.
Resection of the ovary. A technique consisting in the partial removal of an organ along with a cyst. The method is justified in the case of tumor processes, but in modern medicine it is used very rarely, as it involves unpleasant consequences of the organ.
Ovariectomy is a surgical intervention that consists in the complete excision of the ovary along with the cyst. It is used very rarely in cases where the location and size of the formation do not leave a chance for a more gentle operation or there is a threat to the patient's life.

A radical solution to the problem is displayed in the form of consequences such as loss of reproductive function, hormonal imbalance with various complications, but sometimes it is not possible to avoid it.

Laparoscopy

Laparoscopy is performed using a special device and a video camera that makes it possible to remove the ovarian cyst without opening the peritoneum. Instruments are inserted through trocars - conductors that allow you to change instruments without damaging the surrounding tissue. The operation most often requires three such devices - 1 in the navel area (it serves to insert an optical device and a video camera), and 2 - in the lower abdomen - for tools. Laparoscopic incisions are less than 1 cm.

For a better view, carbon dioxide is injected into the cavity - this allows you to raise the anterior wall of the peritoneum. To remove a large cyst, it is placed in a sealed bag, emptied there, and safely removed from the body.

Laparoscopy is very often used at the present stage of development of medicine as the most atraumatic method with a short recovery period. The patient can walk independently a few hours after the operation. A woman can be discharged from the hospital for 2 days (depending on how she feels).

Benefits of laparoscopy:

small cuts;
minimal risk of infection in the postoperative period;
fast recovery;
invisible scars;
minimal discomfort and minor pain;
a small number of restrictions after surgery.

Laparoscopic intervention may consist in extracting the cyst (cyst resection, cystectomy, husking) or excision of the formation together with the ovary (adnexectomy, oophorectomy).

Complete excision of the organ is justified only with menopause or a high risk of developing malignant cells; in all other cases, the specialist must make every effort to preserve the ovarian tissue.

Even in situations where cystic tissues grow into the ovary and completely replace it, it is necessary to ensure the preservation of at least a small number of organ cells - this will give a chance for rehabilitation and reduce the number of complications.

When bleeding occurs, cauterization of tissues and vessels is sometimes used - this is an effective method, but it has a serious drawback. Aggressively treated tissues take longer to recover or even die off. This is tantamount to the destruction of the organ, although this is hardly noticeable to the patient - a healthy ovary will gradually receive a greater load and will work with a vengeance.

The safest way to extract a cyst is the one that does not violate its integrity. It is especially important to use it for mucinous, dermoid, papillary cysts and cystadenoma.

Excision of the foci of the endometrioid cyst requires painstaking work - as many locations as possible should be removed, otherwise the operation will not be effective.

Multifunctionality is recognized as another advantage of laparoscopy - in addition to removing the cyst during the intervention, monitoring can be carried out - to check the patency of the fallopian tubes, remove myomatous nodes, separate adhesions.

Complications during laparoscopy

Despite the minimally invasive operation, it, like all other methods of treatment, has its drawbacks. Complications during laparoscopy range from 1-10% and depend on the level of competence of the doctor and compliance with the recommendations in the postoperative period.

Possible consequences of removing an ovarian cyst by laparoscopy;

Injuries of vessels, soft tissues, internal organs. The most common complication is due to the fact that the formation of a cyst affects the change in the typical location of the internal organs and increases the likelihood of a violation of their integrity.
Infection. The option of infection of the incision is minimal, but there is a threat of exacerbation of the chronic focus of inflammation.
Discomfort due to improper administration of carbon dioxide (entering the retroperitoneal space).

Laparoscopy has fewer complications, so this method of operation should be preferred if it is applicable in the current situation.

Abdominal operation

How is the operation carried out? The surgery is performed under general anesthesia. An incision is made in the lower abdomen of the patient. Through it, the organ affected by the cyst is taken out, the tissues are excised, the ovary is sutured, placed in the cavity and a cosmetic suture is applied.

In the postoperative period, a drainage tube is used (for 1-2 days) to drain blood and fluid. The operation takes about 40 minutes.

In an emergency, abdominal surgery to remove an ovarian cyst is performed according to the following indications:

apoplexy - rupture of the formation with the subsequent entry of its contents into the peritoneum;
breakage of the leg or twisting of the cyst;
a focus of inflammation with further formation of pus with the risk of breaking into the cavity;
rapid growth of the cyst from 4 to 10 cm;
suspicion of malignant cell growth.

Surgery involves the use of general anesthesia and abdominal dissection (which increases blood loss), and this increases the list of contraindications.

Contraindications:

hypertension;
blood pathology;
pre-infarction, pre-stroke state;
diabetes;
serious diseases of the respiratory system;
neoplasms in the genitourinary system, cancer.

The post-operative period and recovery takes up to 2 weeks, then hormone therapy is prescribed. The patient can return to normal life without restriction of physical activity after 2 months.

Complications during abdominal surgery

Manipulations through the incision of the anterior wall of the peritoneum are also displayed during the recovery period - the suture heals longer, there are certain rules for caring for it, and restrictions on physical activity remain for a long time.

Possible complications in the postoperative period:

Violations of the structure of neighboring internal organs.
Bleeding.
Relapse (growth of the cyst again, after a short period of time after the intervention).
Reproductive dysfunction (infertility).
Infection of the seam (in case of injury or improper care).
The development of infection in the abdominal cavity.
Spikes.

How to notice the development of infection in time? Inflammation occurs with all the characteristic symptoms:

swelling and redness (cosmetic scar);
increase in body temperature;
chills;
nausea;
dizziness, weakness;
pain in the lower abdomen;
discharge of a dark color with an unpleasant odor;
increased sweating.

If an infection occurs, additional treatment with antibiotics is prescribed, attention is paid to the treatment of the suture, and the stay in the inpatient department is increased until improvement.

Removal of an ovarian cyst will be effective and will take place without complications if an experienced surgeon who has the necessary information about the patient's condition and the characteristics of the pathology will undertake the operation. After surgery, it is important to follow the doctor's recommendations - to properly care for the suture, limit physical activity and responsibly treat subsequent hormone therapy.

In case of deterioration of health, the appearance of atypical discharge, an increase in body temperature, pain in the lower abdomen, you should immediately seek medical help.

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