Laparoscopic Cyst Surgery

Laparoscopic Ovarian Cyst Surgery in Turkey: Safe Removal of Dermoid and Benign Cysts

What is a dermoid cyst (teratoma)? Learn about the risks of rupture and torsion. Discover fertility-sparing laparoscopic cystectomy for benign and paratubal cysts in Istanbul with Dr. Cengiz Andan.

Risk Management and Safe Surgery for Benign Cysts

Not every cyst found on the ovary is an “Endometrioma” (Chocolate Cyst). Women frequently develop other types of cysts that are generally benign but can lead to the loss of the ovary if neglected. The most common among these are Dermoid Cysts (Teratomas), Simple (Serous) Cysts, and Paratubal Cysts.

At Dr. Cengiz Andan’s Clinic, our fundamental principle in treating these cysts is Ovarian-Sparing Surgery. Regardless of the cyst type, our goal is to preserve the healthy, hormone-producing ovarian tissue containing your eggs.

1. Dermoid Cysts (Teratomas): The Cysts Containing Hair and Teeth

Dermoid cysts originate from embryonic stem cells present since birth. Because of this, they can contain various tissue types found elsewhere in the body, such as hair, teeth, fat, bone, and cartilage.

• Why Surgery is Necessary: Dermoid cysts do not dissolve with medication. Because they contain heavy tissues (like bone and fat), they weigh down the ovary, significantly increasing the risk of Ovarian Torsion (twisting). Torsion cuts off blood flow to the ovary, causing it to die. This is a medical emergency; if surgery is delayed, the ovary may need to be removed.
• Safe Removal with Endobag: Surgery for dermoid cysts requires extreme precision. If the oily/fatty contents of the cyst spill into the abdomen, it can cause “chemical peritonitis” (severe inflammation). Therefore, Dr. Andan places the cyst inside a special surgical bag (Endobag) while still inside the abdomen to remove it safely without rupture or spillage.

2. Paratubal and Simple Cysts

• Paratubal Cysts: These are fluid-filled cysts that form not inside the ovary, but in the area between the ovary and the fallopian tube. While generally harmless, if they grow large, they can compress the tubes or cause torsion. They can be removed laparoscopically without touching the ovary at all.
• Simple (Serous) Cysts: These are cysts filled with clear fluid that typically do not rupture. Surgery is required if they grow larger than 5-6 cm or cause persistent pain.

3. What Happens in Case of Ovarian Torsion (Twisting)?

If a patient presents with severe abdominal pain and it is determined that the cyst has caused the ovary to twist (Torsion), emergency laparoscopy is performed. In the past, twisted and purple (bruised) ovaries were often removed immediately. However, the modern approach is different:

1. The ovary is untwisted (Detorsion) laparoscopically.
2. It is washed with warm water to encourage blood flow.
3. We wait to see if the color returns.

In many cases, ovaries thought to be “dead” revitalize. This allows us to save the organ. Once the ovary is safe, the cyst causing the twist is removed to complete the treatment.

Frequently Asked Questions (FAQ)

1. I have a dermoid cyst; what happens if I don’t have surgery?Answer:Dermoid cysts do not disappear on their own; they tend to grow over time. The biggest risk is ovarian torsion (twisting), which can lead to the loss of the ovary. Additionally, although rare (1-2%), they can undergo malignant transformation in older ages. Therefore, planned surgical removal is the safest route.
2. Will my ovary be damaged during surgery?Answer:Dermoid cysts usually have a distinct boundary separating them from healthy ovarian tissue. An experienced surgeon can use the Stripping Technique to peel the cyst away while preserving the healthy ovarian tissue. The impact on ovarian reserve is minimal.
3. Do I need to take birth control pills after surgery?Answer:Dermoid and paratubal cysts are not caused by hormonal imbalances, so birth control pills will not prevent them from forming or recurring. However, for simple cysts, your doctor may recommend them for a temporary period.
4. Can the pathology result be bad?Answer:98-99% of dermoid and paratubal cysts are benign. However, every removed tissue is sent for pathological examination to provide a definitive diagnosis and rule out any malignancy.
5. When can I shower after surgery?Answer:The tiny laparoscopic incisions are covered with waterproof bandages. You can take a standing shower 1 or 2 days after surgery, either with the bandages on or after removing them.

Dr. Cengiz Andan utilizes advanced laparoscopic techniques to safely remove benign cysts while prioritizing the preservation of your ovaries and future fertility.