Laparoscopically assisted vaginal ovarian cystectomy for clinically diagnosed benign large ovarian masses

Objective: The aim of this study was to present our experience with laparoscopically assisted vaginal ovarian cystectomy (LAVOC) in selected patients with various large ovarian masses. Materials and Methods: Among the medical records of 324 patients with ovarian masses, 10 consecutive women of reproductive age with prior sexual activity and with large ovarian masses (10-27′cm) were evaluated. A combined laparoscopic and vaginal ovarian cystectomy was done through the posterior cul-de-sac. Results: All operations proceeded smoothly; the ovarian pathologies included 1 mucinous cystadenoma, 1 serous cystadenoma, 1 mucinous cystadenoma coexisting with mature cystic teratoma, and 7 mature cystic teratomas. The median (range) tumor size was 15.5′cm (range, 10-27), operative duration was 62 minutes (range, 31-110), the estimated blood loss 50′mL (range, 10-150), and the hospital stay was 2 days (range, 1-4). No open conversion and blood transfusion was required, and no patient had major perioperative complications. One patient suffered from postoperative low-grade fever (<38.5°C) controlled by 3-day parenteral antibiotic therapy. Conclusions: LAVOC is safe and feasible and can be an alternative to traditional laparotomy and the pure laparoscopic approach in selected patients. The potential risk of postoperative infection has to be kept in mind.