The Use of Ovarian Wall as an Endobag During Laparoscopic Removal of a Giant Dermoid Cyst: A New Approach

Incidental finding of an asymptomatic giant ovarian mass is unusual during pregnancy. Addressing such voluminous cysts laparoscopically is controversial, and a challenge to the surgeon. This article describes on how we tackled a 27-cm ovarian cyst using the ovarian wall itself as the endobag.
A 32-year-old lady was referred to Obstetrics and Gynecology Department at 9 weeks of gestation with missed miscarriage and an incidental finding of a huge ovarian cyst by ultrasonography. After evaluation and obtaining informed consent, laparoscopy was performed. We elaborate here on how this huge mass was excised laparoscopically, minimizing intraperitoneal spillage by using the ovarian wall itself as endobag. The histopathology report confirmed a mature cystic teratoma. The postoperative period was uneventful.
Many surgeons have a phobia to tackle giant ovarian cysts laparoscopically, due to fear of malignancy and spillage of contents, despite the inherent advantages of the minimal access surgery. We hope that this case report will add to the increasing evidence on the safety and efficacy of tackling such giant cysts laparoscopically.