LAPAROSCOPIC OVARIAN CYSTECTOMY

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1 LAPAROSCOPIC OVARIAN CYSTECTOMY Information Leaflet Your Health. Our Priority.

2 Page 2 of 5 About this information This leaflet is for you if you have a cyst on one or both ovaries and are considering surgery. It will help you and your doctor to make the best decisions for your care, but does not replace advice from a doctor about your specific situation. This leaflet should be read along with the leaflet titled Recovering well after a laparoscopy ( What are ovarian cysts? An ovarian cyst is a fluid-filled sac that can grow from the ovary, and can vary in size. The cyst may contain fluid only (simple cyst) or be more complex containing blood, fluid, or solid areas. The commonest causes of ovarian cysts are: Simple cyst this is usually a large follicle in the ovary that has grown after an egg is released; this is the most common cyst before the menopause and often will disappear after a few months. Endometrioma (chocolate cyst) often found in women with endometriosis, where the cells of the lining of the womb can be found outside the womb and may form cysts on the ovary Dermoid cyst this grows from the cells that make up the ovary, and may contain structures such as hair and fat Benign (Non-cancerous ) cysts Very rarely, cancer of the ovary can be detected from ovarian cysts. You may have no symptoms from it, or you may suffer from: Lower abdominal pain Painful periods or pain with intercourse Changes to bowel or bladder habit Change to appetite and feeling fuller quicker or bloating What tests can be done? You will be seen by a specialist Gynaecology Doctor who will ask you questions and may perform an examination of your abdomen and internal (vaginal) examination. An ultrasound scan will be performed to look at your ovaries, and this is usually a scan on the abdomen and through the vagina. An ultrasound scan cannot always tell the difference between a cyst on the ovary, and a cyst on other nearby structures such as fallopian tube or bowel. If there is any doubt about the location of a cyst, you may be offered a more detailed scan, such as CT (computer tomography) or MRI (magnetic resonance imaging) scan at a later date.

3 Page 3 of 5 If your cyst appears complex, you may be offered blood tests to help determine what type of cyst it is. What are the treatment options available to me? Broadly speaking, the options are to watch and wait or have an operation to surgically remove the cyst. When should I consider watch and wait? If you have a simple cyst less than 5cm and you have no symptoms If you have a simple cyst 5 to 7cm and minimal symptoms If significant operative difficulty is anticipated, such as very high BMI (very overweight) or multiple previous abdominal surgeries. You will most likely receive a follow up scan at an interval to check for resolution, and if you are still well, may be discharged. When should I consider surgery? Symptoms likely to be from the cyst (and not other causes) Cyst still present after a period of watch and wait Simple cysts over 5cm with symptoms Complex cysts When the underlying cause of the cyst cannot be concluded How is the operation performed? Laparoscopic ovarian cystectomy is keyhole surgery to remove the ovarian cyst and leave the ovary in place. It is usually a day case procedure, meaning that you have a General Anaesthetic, but are discharged home later the same day. In laparoscopic surgery a small camera is passed through a small (2-3cm) incision in your belly button. You may have two to four other smaller incisions on your abdomen in addition, which may be around the pubic hair line or above your hip bones. What are the risks? Serious risks include: Overall risk of serious complications from laparoscopy is 2 in 1000 (uncommon) Damage to bowel, bladder, uterus, major blood vessels requiring further repair is uncommon Delay in detection of injured structures occurs in 15% of cases Failure to gain entry into the abdominal cavity and complete the intended surgery Hernia at entry sites on the abdomen Loss of function of the ovary that is left in Removal of the ovary attached to the cyst, if there is excessive bleeding, or if the cyst has mostly replaced the ovary Death is a very rare complication of laparoscopy and may occur in 3 to 8 women in every 100,000.

4 Page 4 of 5 Frequent risks include: Wound bruising, shoulder tip pain, wound infection or gaping Extra procedures necessary during the operation may include: Laparotomy (A larger cut on your tummy) Repair injured structures Blood transfusion Delayed risks include: Scarring in the pelvis/abdomen Chronic pain What happens after the operation? You will usually be able to go home when you feel ready. Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment. The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure, they usually disappear in about two to three weeks. You will usually feel well enough to go back to your normal activities one to three weeks after the procedure. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. Anything else I need to know? The oral contraceptive pill may be helpful in reducing the risk of another ovarian cyst. Speak to your GP to see if you are suitable to go on the Pill. If you are known to have an ovarian cyst and have not yet had surgery, it is important that you seek early medical advice if you experience severe abdominal pain that is not relieved with simple painkillers. On occasion, large cysts can twist (torsion) or bleed into themselves (haemorrhage) or burst (rupture) and this may require emergency surgery. Please read the patient information leaflet about laparoscopy and ask your Gynaecologist or GP if there are any other questions that you have. Contact us Jasmine Ward

5 Page 5 of 5 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number MAT198 Publication date December 2015 Review date December 2017 Department Gynaecology Location Stepping Hill Hospital

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