Laparoscopic surgery for ovarian cysts.

Laparoscopic surgery for ovarian cysts is one of the most frequent laparoscopic surgical procedures performed presently. The routine use of pelvic imaging (sonography), in the case of any gynaecological symptom or as a screening method in women at risk, explains why more and more ovarian cysts are encountered. The diagnostic and therapeutic challenge for the clinician to provide the best immediate and long-term benefits for the patient is to identify pre-operatively not only an ovarian malignancy (to be treated in a conventional way) but also functional cysts (usually disappearing spontaneously and requiring no form of treatment in most cases). Ideally, only benign 'organic' cysts should be treated laparoscopically. The technical aspects and the benefits of this approach have been documented extensively in recent years. The routine use of the 'closed technique' and of an impermeable bag for removal should limit the risk of spillage of the cyst contents with its inherent potential problems (chemical peritonitis, malignant cell dissemination and parietal implantation into the laparoscopic port sites). The adnexal torsion can be also properly managed by laparoscopic surgery.