Dermoid cyst – by hydro dissection

Authors: Devang Kanuga
WINGS- Women’s Institute of Infertility and Gynecological Endoscopic Surgery
Ahmedabad, India

A seventeen year old patient came to our observation presenting a 6 cm dermoid cyst in the right ovary. A laparoscopy was planned.
The ovarian parenchyma over the cyst was opened with scissors. It is recommended to start cutting where the ovarian parenchyma is thicker otherwise sometimes finding the cleavage plane is difficult and the cyst may get ruptured and subsequent spillage in the abdominal cavity.

The dissection of the cyst from the ovary was carried out by HYDRODISSECTION using suction irrigation cannula. Using this device, If spillage does occur, immediate suction is immediately possible. Spillage prevention is important in case of dermoid cyst: the content causes a chemical peritonitis that will cause significant thick fibrous adhesion in the post operative period..

Suturing reconstruction of the ovary if the size of the cyst is more than 5 cm, may help to achieve the haemostasis and avoid using excessive thermal energy.
The specimen was carried out through an endobag to avoid spillage.
A thorough peritoneal washing is recommended at the end of the surgery.