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Operations: Ovarian cystectomy (not included in other procedures)

Insurance code: Q4400

Introduction: This information is written by John Fairbank and is provided for the benefit of his patients. Additional information will be given during consultation in the clinic and during the pre-operative discussion. It is not appropriate for all surgeons’ individual practice or for all patients.

Purpose of operation: The operation of ovarian cystectomy is to remove an ovarian cyst from the substance of the ovary and then repair the ovary. The cyst wall is sent for pathology and the ovary repaired so that it will continue to function. This procedure can sometimes be carried out using laparoscopic techniques.

Details of procedure: A catheter is placed in the bladder to drain off all the urine and protect the bladder from surgical damage. The abdominal cavity is opened through a transverse supra-pubic (bikini line) or midline vertical abdominal incision. The ovaries are inspected to determine how many ovarian cysts are present and whether both ovaries are affected. The cyst is inspected to ensure the ovarian cysts do not have any malignant features. If there is evidence of cancer it is better to remove all ovarian tissue rather than conserve the ovaries. The wall of the ovary overlying the cyst is opened and the ovarian cyst is carefully dissected trying not to spill its contents. Once the cyst has been removed the wall of the ovary is repaired with some fine sutures. The pelvis is washed out and the abdomen closed in layers with strong sutures. The skin is closed with fine sutures.

Anaesthetic These operations are usually carried out under general anaesthetic.

Length of stay A ‘bikini’ line incision normally allows for a three to four night stay and a vertical midline incision normally requires a five night stay.

Post-operative management The catheter is normally removed the following day. The IV fluid line is left in place until oral fluids are tolerated. The painkilling pump is kept in place until it is no longer required. Stitches or skin staples are normally removed the days of discharge from hospital.

Potential complications
Complications at the time of surgery include peri-operative bleeding, and damage to structures such as bladder and bowel. These complications are rare but require corrective surgery immediately or as soon as a problem is recognised. Venous thrombosis (DVT) can follow any pelvic surgery. Stockings are therefore worn and heparin injections given each day to reduce the risk. Early mobilisation and early discharge from hospital reduce the risk of thrombosis

Post-operative consultation
A routine appointment is normally booked for four weeks to ensure the wound is well healed although other appointments may be necessary to ensure the post-operative course goes smoothly.

Post-operative management
Sex is best avoided until the skin has healed and sutures have dissolved. This may take up to four weeks. Heavy lifting is best avoided for three months to prevent stitches giving way but light lifting is not a problem. Driving short distances is practical once comfortable and strong sedative pain killers are no longer being taken.

Other considerations
Ovarian cysts can sometimes be removed using laparocopic techniques although the practicality of laparoscopic surgery depends on the nature and size of the ovarian cyst.

Relevant websites

Information on ovarian cysts

General chat about ovarian cysts

Information on ovarian cysts