Transumbilical Single-port Laparoscopic Ovarian Cyst Excision With Protection of Ovarian Function / 中国微创外科杂志

ABSTRACT

Objective To investigate the clinical application value of transumbilical single-port laparoscopic ovarian cyst excision with protection of ovarian function.Methods From July 2018 to December 2019,we performed 56 cases of single-port laparoscopic ovarian cyst debulking,in which the umbilicus was incised transversely for about 2 cm and a single-port trocar puncture was placed to form an artificial pneumoperitoneum.The ultrasonic knife was used to avoid the ovarian hilum and cut the ovarian cortex on the opposite side of the ovary to ensure a good blood supply.The ovary on the affected side was fixed to facilitate blunt separation of the cyst and preserve the normal tissues of the ovary as much as possible.The 2-0 absorbable suture was applied for hemostasis and ovarian reconstruction.Results The operations were successfully completed in all the 56 cases,including bilateral ovarian cyst excision in 3 cases,salpingectomy in 3 cases,tubal mesangial cyst excision in 1 case,hysteromyomectomy in 2 cases,appendectomy in 1 case(an additional puncture hole was added due to the need for abdominal drainage after the operation),hysteroscopic resection of endometrial polyps in 1 case,and pelvic adhesion release in 1 case.The operation time was(72.0±30.0)min,and the postoperative hospitalization time was(5.0±0.6)d.No complication occurred.The 56 patients were followed up for 2-3 years,with an average of 1.5 years,with no complications,poor wound healing,or recurrence of ovarian cysts.There was no significant difference in the number of ovarian antral follicles between 6 and 12 months after surgery and before surgery[7.02±1.57 vs.7.05±1.55,P = 1.000;6.93±1.46 vs.7.05±1.55,P =1.000].There was no significant difference in ovarian stromal blood flow(P>0.05),indicating no decrease in ovarian function.Conclusion The key to protecting ovarian function is the rational selection of surgical instruments and incisions,precise performance of resection of ovarian cysts,and protection of ovarian blood supply.