Ovarian Cyst Removal

Definition

Removal of a cyst on an ovary

Parts of the Body Involved

  • Ovary, one or both

Reasons for Procedure

To remove a cyst that is:

  • Suspected of being cancerous
  • Large (more than 2.5 inches in diameter)
  • Solid
  • Causing pain
  • Twisted

The chance that a cyst is cancerous increases with age. The older the patient, the more likely an ovarian cyst will be removed.

Risk Factors for Complications During the Procedure

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Review of medications
  • Blood tests
  • Urine test
  • CT scan—a type of x-ray that uses a computer to make pictures of the pelvis and pelvic organs
  • Ultrasound—a test that uses sound waves to examine the abdomen
  • X-ray of chest, lower intestinal tract, and lower abdomen
  • Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
  • Culdocentesis—removal of fluid from the pelvic cavity for exam

Talk to your doctor about what action should be taken during the surgery if cancer is found. One option is to remove the ovary.

In the days leading up to your procedure:

  • Do not take aspirin, aspirin-containing products, or anti-inflammatory drugs (such as ibuprofen) for one week before the procedure.
  • Arrange for a ride to and from the hospital.
  • Do not eat or drink for at least eight hours before the procedure.

Anesthesia

This depends on the type of procedure. General anesthesia is used for open surgery, and general or local is used for laparoscopic surgery.

Description of the Procedure

There are two methods to remove an ovarian cyst: laparoscopic surgery and open surgery. The method used depends on the type and condition of the cyst being removed. Open surgery is often done for larger cysts.

Laparoscopic Surgery

A very small incision is made just below the navel. Through this cut, the surgeon inserts a laparoscope, which is a thin, lighted tube. Carbon dioxide gas is pumped into the abdomen. This inflates it and makes it easier for the surgeon to view the organs. The laparoscope is then used to locate the cyst. Once located, one or two more tiny incisions are made. Surgical tools are then inserted to remove the cyst.

Depending on the situation, the surgeon may send the removed tissue to the lab. If cancer is detected, the ovary or both ovaries (if cysts are found on both ovaries) may be removed. Depending on the situation, ovary removal (oophorectomy) may be done laparoscopically or may require a classic open incision. Once the cyst, ovary (maybe), and tools are removed, the incisions are closed with stitches or clamps.

Laparoscopic Ovary Removal

laparoscopic hysterectomy

© 2008 Nucleus Medical Art, Inc.

Open Surgery

An incision is made in the abdomen, the abdominal muscles are separated, and the abdomen is opened. Blood vessels that supply the ovaries are located, clamped, and tied. The cyst is removed. Depending on the situation, the surgeon may send the removed tissue to the lab. If cancer is detected, the ovary or both ovaries (if cysts are found on both ovaries) may be removed. The tools are removed, the abdomen is closed, the abdominal muscles are sewn together with heavy stitches, and the incision is closed with stitches or clamps.

After Procedure

Intravenous fluids and medications will be given.

How Long Will It Take?

1-2 hours

Will It Hurt?

Anesthesia prevents pain during surgery. However, you may have abdominal pain or discomfort for 3-4 days after laparoscopic surgery and for 7-10 days after open surgery.

Possible Complications

  • Infection
  • Excessive bleeding
  • Recurrence of ovarian cysts
  • Recurrence of cancer
  • Need for removal of one or both ovaries
  • Infertility
  • Blood clots
  • Need to change from planned laparoscopic surgery to classic open abdominal incision
  • Shoulder pain from the carbon dioxide gas used during the procedure

Average Hospital Stay

  • 0-1 days for laparoscopic surgery
  • 5-7 days for open surgery

Postoperative Care

  • Move and elevate your legs while resting in bed. This will lessen the chance of blood clots.
  • Do not take prescription pain medication for more than seven days.
  • After seven days, take nonprescription pain relievers such as Advil and Naprosyn.
  • Avoid strenuous exercise for two weeks after a laparoscopic procedure and six weeks after an open procedure.
  • Do not resume sexual activity, use tampons, or douche until your doctor says it is fine (usually after follow-up exam two weeks after surgery).
  • Bathe or shower as normal.
  • Wash the incision area gently with mild soap until it heals fully.
  • To help speed healing and recovery, resume normal activities (including work) as soon after surgery as you feel able.
  • If you have been diagnosed with certain types of cysts that are known to recur, follow your doctor's guidelines for follow-up ultrasound exams.

Outcome

If no cancer is detected, you will fully recover and can resume all normal activities. It may take 1-2 weeks for full recovery from laparoscopic surgery. It may take 3-4 weeks after open surgery.

If cancer is detected, you may have one or both of your ovaries removed, either during the ovarian cyst surgery, or during follow-up surgery. Your doctor will discuss your condition and treatment options with you. Further treatment may include additional surgery, chemotherapy, and/or radiation therapy.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Headaches, muscle aches, dizziness, fever, or general ill feeling
  • Constipation or abdominal swelling
  • Vomiting
  • New, unexplained symptoms

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org/

The National Women's Health Information Center
http://www.4woman.gov/

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/

Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm/

References:

Medical encyclopedia: pelvic laparoscopy. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002916.htm. Accessed October 14, 2005.

Ovarian cysts. Mayo Foundation for Medical Education and Research website. Available at: http://www.mayoclinic.com/health/ovarian-cysts/DS00129/DSECTION=7. Updated July 20, 2007. Accessed June 10, 2008.



Last reviewed January 2008 by Jeff Andrews, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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