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.