Laparoscopic Surgery for Left Ovarian Dermoid Cyst

Aaradhya Sharma

https://www.laparoscopyhospital.com/SERV01.HTM  This video demonstrates Laparoscopic Surgery for a Left Ovarian Dermoid Cyst. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis). Laparoscopic management of dermoid cysts is a safe and beneficial method in selected patients when performed by an experienced laparoscopic surgeon.  For more information please contact:  World Laparoscopy Hospital  Cyber City, Gurugram, NCR DELHI  INDIA 122002  Phone & WhatsApp: +919811416838, + 91 9999677788

Transcript

00:00hello friends this is a case of left-sided ovarian dermoid and this

00:07patient has a approximately four centimeter dermoid cyst so we will

00:11perform laparoscopic surgery for ovarian dermoid cyst and this patient has he

00:19sees unmarried girl so we will not do the lithotomy position and we will not

00:23use uterine manipulated also with the simple supine position we will perform

00:28the surgery and we will remove the dermoid cyst by commercially available endo

00:34bag so let us see this surgery and we hope that you will like it here this is

00:40the left-sided ovarian dermoid

01:01so the probable location of this cyst will be here although we will confirm after

01:07entering the telescope inside but this will be the probable location of the

01:12dermoid cyst here and according to baseball diamond concept here we will put the

01:18telescope in the inferior crease of umbilicus because we want the minimum

01:24scar and this is not a large cyst so we will put over the inferior crease of

01:29umbilicus so a small stab wound will be given and after that you can just put the

01:35various needle and lift the abdominal wall and go perpendicular to the abdominal wall

01:40but oblique to the body of the percent here this is one and two click and you can

01:45enter inside the abdomen after that as usual we will perform the irrigation test and

01:51followed by suction test and then hanging drop test as you know hanging drop test is

01:59very important which will suck the fluid in and it will make it sure that it is going

02:03inside so now all the test is over and then we will attach the tubing of the

02:10insufflator and as usual insufflator we generally use the preset pressure 15 and

02:17the initial flow rate is 1 liter per minute and total amount of gas used

02:24minimum 1.5 maximum 6 and in that much gas automatically actual pressure will reach

02:31to the preset pressure so here slowly we will wait till the insufflator will give

02:36its reading as we can see preset pressure is 15 and actual pressure is

02:41slowly rising and once 15 is reached we will remove the various needle and then

02:47enlarge the incision and the incision will be enlarged to 11 mm

02:52so this is a labunemum incision after that you can take one small mosquito forcep and you

03:06can just try to dilate the obliterated with low intestinal tract as we know it is called

03:13as a Scandinavian technique and in that there is a minimum chance of infection and minimum chances

03:20of hernia because you are in the dry surface and we don't go through the base of the

03:26umbilicus now head of the trocar should rest over thin armenes middle fingers should wrap

03:33around the air inlet and index finger should be pointed towards the sharp end and then the

03:39first primary trocar will be introduced by just supporting or two hand technique

03:45they are both the technique perpendicular to the abdominal wall again tubing of the insufflator

03:54will be attached and the flow rate will be now 6 to 10 liter per minute and here we can see now

04:02this is the telescope inside and according to baseball diamond concept you will put the index finger

04:08over the target and this is one snuff box is one port and another again 7.5 cm lateral will be the

04:17other port so after filling the abdominal cavity with the pneumoperitonium under vision these ports

04:23will be introduced and initially you should do diagnostic laparoscopy patient head is slowly going down down down

04:30and patient head will be 30 degree down so that easily you can push the bovel away and you can move the all the small interest

04:39time and even the cecum and appendix all will be pushed and then move it below momentum also should be pulled down

04:49left sided sigma and colon also has to be little bit displaced and then with the left side you will hold the

04:56ovary and with the right side you can open the outer ovarian cortex and after opening the outer ovarian cortex

05:04without rupturing also it is possible to perform the surgery although sometime it gets ruptured but most

05:11of the time if you are little careful you can prevent rupturing the ovary you have to use here ambidexity

05:19both the hands should be used left hand you will use atraumatic rasper and with the right hand with

05:26the meri land you can keep on stripping the ovary and cortex slowly by opening the jaw of the meri land

05:34you can make a good plane and once a good plane is formed after that ovary will come out without

05:40rupturing so this is how you can hold it and then again catch the cyst with the right hand and transfer it

05:48into the left hand so this way slowly slowly ovary and cystectomy can be performed without rupturing

05:55it although if it ruptures immediately we have to take a measure copious lavage has to be performed

06:01in many situations we keep the endobag first inside the abdomen and after that we will open the

06:08ovarian cyst inside the endobag so this is slowly slowly the entire cyst is coming out

06:15and by sweeping movement of the jaw of the meri land you can achieve a good plane

06:28so now almost all the cyst intact without puncturing is out and then simply you will drop one endobag

06:39and you will drop this ovary in the endobag and then take it out with the 10 mm umbilical port

06:48so friends thank you very much for watching this video this was just a simple case of dermoyad

06:53for watching this video we were looking forward to watching this video this video is more

07:04of a great like this video now.

07:06Let us see you in the next video and see how the video was,

07:10let us see if you can find out or feel a little better after doing this video.

07:13Let us see if you can find out and see the video and see how the video be selected and see

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