Laparoscopic Excision/Removal of Benign Mass on Ovaries and Tubes
Abnormal or large masses on ovaries and/or tubes are commonly detected on different imaging techniques such as ultrasound (sonogram), CT scan and MRI. If clinically indicated, surgery is being performed. Usually the nature of those masses is benign, such as endometrioma, dermoid, serous or mucinous cystadenoma, hydrosalpinx, fibroma, etc. In most cases a significant abdominal incision is being performed (laparotomy) though a minimally invasive procedure (laparoscopy) could be used instead.

Laparotomy requires an inpatient stay of 2-3 days and recovery at home of 4-6 weeks. Laparoscopy is an outpatient procedure with only 1-2 weeks recovery time at home.

The usual reasoning against laparoscopic approach in these cases is – what if the mass turns out to be cancerous and inadvertent spillage occurs during laparoscopic surgery? In fact, spillage may occur both during laparotomy and laparoscopy. By placing the resected mass into a special laparoscopic sac the spillage is being prevented, the contents of the sac are being securely removed and sent for frozen section (quick pathology test) while the patient is still asleep. If pathology turns out to show cancer (which is uncommon), laparoscopy is being converted to laparotomy and definitive surgery for cancer is being performed. Careful preoperative workup for correct clinical diagnosis of a benign mass (exclusion of cancerous mass) should reduce the risk of conversion from laparoscopy to laparotomy to a minimum.