Large
ovarian cysts
usually occur for several reasons that include laxity on
part of the patient who overlooks the usual symptoms
that accompany the formation of the cyst, like
tenderness and pain in the abdomen, feeling of
heaviness, unusually heavy bleeding and irregular
menses. Waving aside the symptoms as part of menstrual
disarray, the patient inadvertently allows to the cyst
to grow bigger till it makes life unbearable.
Despite
the fact that cysts may be diagnosed earlier through
ultrasound, laparoscopic procedures, CT scanning,
Magnetic resonance, etc, women often tend to ignore the
symptoms for reasons known to them only. Sometimes,
emotional factors also work for non-removal of dermoid
cysts.
However,
one can not lead a normal life with one or more
grapefruits loaded in the tummy and a time eventually
comes when its removal becomes necessary. But by then it
becomes pretty late for a lesser-invasive laparoscopic
surgery that is often performed for removal of smaller
cysts. Laparotomy, which is a more complicated open type
surgery that requires expensive surgical apparatus and
exclusive environs are involved in removal of large
ovarian cysts.
Nonetheless,
an innovative minilaparotomy
technique for the removal of large benign ovarian cysts
is available now that offers the advantages of
laparoscopic as well as laparoscopy-assisted procedures
while bypassing major disadvantages like the need for
specialized expensive equipment, lengthy operative time
and related factors. The procedure is also less
expensive, faster, carrying lesser potential risks, as
compared to traditional alternatives; while offering
advantages that include use of inexpensive appliances,
use of regional anesthesia, elimination of the risk of
intra-peritoneal spillage of cyst contents and minimal
convalescence.
After
the administration of general or regional anesthesia,
the patient is placed in the changed lithotomy position
for the laparoscopic surgery. Arms may be tucked at the
side of the torso while the legs may be placed in
stirrup boots. Hip flexion may be avoided while thigh
abduction should be allowed for exposing the vagina.
Careful examination of the pelvic area may be done at
this stage to find out the adnexal mass’s dimension and
mobility.
A
small suprapubic transverse incision is made with the
help of a regular scalpel through the subcutaneous
tissue and the skin. After clearing the subcutaneous
fat, incision of the peritoneum and the rectus fascia is
done vertically. Small bleeding points may be controlled
with Bovie device and the peritoneum may be entered
either digitally or with scissors above the bladder
dome. A soft and sleevy plastic retractor is often used
here, as when it is properly placed, it enables the
pelvic area to be better exposed.
The
cyst may now be inspected visually and digitally while
the extent of adhesion and unanticipated pelvic
pathology may be determined. In order to remove a
large cyst in the ovary using the Pelosi
minilaparotomy, the cyst dimension may be reduced by
decompression. Several devices are available to do so
without the chance of spillage. The cyst may now be
safely aspirated, without causing damage to the ovary or
other significant organs. Using a gauge pad, the area of
the ovarian cyst that is visible through the retractor
may now be carefully dried after which surgical glue
that works as alternative to stitches may be applied to
close the edges of all wounds.
Before
concluding the procedure, the peritoneal cavity may be
irrigated to remove any remnants of cyst contents that
might have spilled while the self-retaining retractor
may be removed by hooking a finger through the bottom
ring and pulling it out gently out of the incision.
Closing the cruciate incision is quicker and a vertical
pressure dressing over the incision will prevent
postoperative wound haematoma or seroma
formation.
The
holistic approach has become popular in recent years as
a cure for many diseases including ovarian cysts.
‘Holism’ has been linked to maintaining good health for
years now, but it has been integrated with the
mainstream ‘Health care System’ is a recent development.
The fact is, the holistic approach cures cysts in the
ovary completely, and it also prevents its occurring
through altered diet, healthy habits and change of
lifestyle. Holistic method is not merely a technique
adopted in curing a disease condition; it is an ideal
concept for doing so, involving a mighty lot of factors
that govern our bodily functions.
