Laparoscopic management of large ovarian endometrial cyst: use of fibrin sealant.

In order to prevent postoperative adhesions often present after CO 2 laser vaporization of large endometriomas, 62 patients with endometriomas greater than 3 cm diameter were treated with a new procedure. Partial cystectomy was performed using the CO 2 laser. Residual endometrial cyst was then vaporized. After laparoscopic vaporization of the interior cyst wall, a fibrin glue (Tissucol) was injected onto the vaporized area to close laparoscopically the ovarian cyst cavity. When performed, second-look laparoscopy demonstrated healing of the ovary without any periovarian adhesions. The incidence of periovarian adhesions was significantly lower (p less than 0.01) than in the group of women treated by laparoscopy and in whom the glue was not used to close the ovarian cyst cavity.