What is Cystectomy?
Cystectomy is the surgical excision of an ovarian cyst. Ovarian cysts are small fluid-filled sacs that develop on the ovaries.
Ovaries are almond-shaped organs located one on each side of the uterus. Once a month, during your menstrual cycle, a follicle forms on your ovary. A follicle is a fluid-filled sac that contains an egg. Usually, a follicle releases a mature egg from your ovary (ovulation). In some cases, if the follicle fails to rupture and release an egg, the fluid stays in the follicle and forms a cyst. This is called an ovarian cyst. Some women may experience pressure, swelling, pain in the abdomen, pain during intercourse and abnormal or unusually painful periods.
Your doctor may feel the presence of an ovarian cyst during a pelvic examination. An ultrasound test may be done to examine the pelvic organs and for diagnosing an ovarian cyst. Your doctor may perform a blood test to check the levels of several hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), oestradiol and testosterone. The CA-125 blood test is also done to find out if the cyst is cancerous. A pregnancy test may be performed to rule out pregnancy. Cysts can also be detected with other imaging tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI) scan and Doppler flow studies.
Most ovarian cysts will resolve on their own without any treatment. Birth control pills may be prescribed to reduce the formation of new ovarian cysts. Surgery is an option if the cyst does not go away, grows larger in size or causes pain, and in menopausal women or those nearing menopause.
Procedure of Cystectomy
Cystectomy is a surgical procedure during which the ovarian cyst is removed either with laparoscopy or open surgery. A laparoscopic cystectomy procedure is a minimally invasive surgery during which a laparoscope, a long thin instrument with a camera attached at one end, is used. The procedure is usually done under general anaesthesia and a small incision is made below your navel. A laparoscope is inserted through this incision to look inside your pelvis and abdomen. Carbon dioxide gas is introduced into the abdominal cavity to create more space to work. Your surgeon identifies the cyst through the scope and removes it with surgical instruments inserted through other small incisions. This technique is usually used to remove small cysts, leaving the ovaries intact.
However, if the cyst is too large or connected to ovarian tissue, your surgeon removes all or part of the ovary. Laparotomy is an open surgical exploration of the abdomen to examine the organs of the abdomen. You will be administered general anaesthesia and a single, large cut is made through the abdominal wall. Then the abdominal muscles are separated to reach your ovary. In some cases, the blood vessels supplying the ovary are clamped and tied off. Then the cyst is removed. Alternatively, samples of tissues may be removed for further analysis. If the cyst is cancerous, your doctor may need to take out the affected ovary. The abdominal muscles are sewed and the incision is closed with stitches.
Following ovarian cyst removal, complete recovery usually takes about one to two weeks. Your doctor may prescribe anti-inflammatory medications to help relieve your pain.
Complications Associated with Ovarian Cyst
The specific complications associated with ovarian cyst removal include the need for removal of one or both ovaries, injury to the surrounding organs, damage to the fallopian tube(s), damage to the womb and infection.
When you are recommended for a cystectomy, your surgeon decides whether to use a laparoscopic procedure or open surgery.