Ovarian Cystectomy / Oophorectomy
Ovarian cystectomy involves the removal of the ovarian cyst from the ovary whilst oophorectomy involves removal of the whole ovary, usually with the attached fallopian tube. This is done by operative laparoscopy and which one is undertaken depends on various factors as outlined in ‘ovarian cysts’.
In this operation the ‘plane’ between the normal ovary and the ovarian cyst is identified and the cyst peeled away from the ovary. This usually leaves a raw area on the ovary which can bleed. This is stopped by cauterising the area. Very occasionally, if the bleeding cannot be controlled by cautery it is necessary to remove the ovary. The cyst, once separated, is removed from the abdomen through one of the ‘keyhole’ incisions either directly or having been placed in a retrieval bag that is introduced into the abdomen via one of the ports.
In some situations, if the raw area on or under the ovary is large the ovary may be temporarily stitched to a ligament to keep it from touching the side of the pelvis and thereby hopefully prevent it sticking to the area as it heals. This is called ‘temporary ovarian suspension’. The stitch used to do this is rapidly dissolving and once dissolved the ovary should fall back to its normal position having had time to heal. In addition a solution will be left in your abdomen to try to prevent the bowel sticking to any raw areas. This is outlined in operative laparoscopy.
Removal of the ovary and its associated fallopian tube requires the ovary to be dissected free of surrounding structures. The ovarian artery is then cut and sealed using heat or vibration energy and the remainder of the attachments are then divided. The ovary is then usually removed from the abdomen in a retrieval bag, through one of the laparoscopic (keyhole) ports