This video demonstrates the Ovarian Cystectomy by Wrapping Technique by Dr. R K Mishra at World Laparoscopy Hospital. Laparoscopic ovarian cystectomy is a minimally invasive surgical procedure that uses small incisions and a camera to remove ovarian cysts. The steps involved in a laparoscopic ovarian cystectomy are as follows:
Pre-operative evaluation: Before the procedure, the patient will undergo a thorough evaluation, including a physical examination, medical history, and imaging tests, such as ultrasound or MRI.
Anesthesia: The patient will be given general anesthesia to ensure that they are unconscious and pain-free during the surgery.
Incisions: The surgeon will make a few small incisions in the abdomen, usually no larger than a few millimeters each. These incisions will be used to insert the laparoscope and other surgical instruments.
Insertion of the laparoscope: The laparoscope is a small camera that is inserted through one of the incisions. It will allow the surgeon to see the ovaries and cysts on a monitor.
Exposure: The surgeon will use specialized instruments to gently pull apart the muscles and tissues to expose the ovary and the cyst.
Separation of the cyst: Using specialized surgical instruments, the surgeon will carefully separate the cyst from the surrounding tissues and blood vessels, taking care not to damage the ovary.
Removal of the cyst: Once the cyst has been separated, the surgeon will carefully remove it from the ovary, ensuring that all of the cystic fluid and tissue is completely evacuated.
Closure: The surgeon will then close the incisions using sutures or surgical glue.
Post-operative care: After the procedure, the patient will be closely monitored for any signs of complications, such as bleeding or infection. The patient may be able to go home on the same day or the next day, depending on the individual case.
Follow-up: The patient will need to follow up with the surgeon for a post-operative evaluation to ensure that the cyst has been completely removed and that there are no signs of complications. The patient may need to have regular follow-up appointments to monitor their ovarian health.
Like any surgical procedure, laparoscopic ovarian cystectomy also carries a risk of complications. Some potential complications of laparoscopic ovarian cystectomy include:
Bleeding: There is a risk of bleeding during the procedure, which can be managed by the surgeon.
Infection: There is a risk of infection, which can occur in the incision sites or in the pelvic area. The patient may be prescribed antibiotics to prevent infection.
00:00Hello friends, this is a case of laparoscopic ovarian cystectomy and here we will show you
00:14how to do the ovarian cystectomy by wrapping technique. This technique is very famous all
00:20over world and gynecologist they use it to stabilize the cystic valve while they are
00:28separating the cyst from the ovarian cortex. So, we can see this is a left sided ovarian
00:33cyst, but it has little torsion and it is reaching to the right side. So, first we will do the
00:40aspiration and then detorsion will be performed. So, this is simple cyst, but it is little large
00:50approximately 7 centimeter of the cyst. So, first step is that we will do aspiration.
00:58So, this is aspiration needle which is doing the aspiration of the ovarian cyst. This was
01:07a simple ovarian cyst which was confirmed by the MRI. So, we are not using any endo bag,
01:15if it would have been dermoid or any endometrioma, then we will do it after putting inside the
01:22endo bag. So, we can see cyst is deflating and the suction is attached with the aspiration
01:34needle and all the fluid of the ovarian cyst is sucked out.
01:41So, let us see what we will do. So, after that we will hope that we will hope that the
02:11and hold the anti-mejo-ovarian the detorsion is done and the anti-mejo-ovarian border of
02:16the cyst and with the harmonic just a small incision will be given over the ovarian cortex.
02:25A little bit tearing will be performed so that the cystic valve will be separately visible.
02:38Now left hand has a grasper and right hand has a Maryland and this is the inner cystic valve
02:45which is a stripping from the outer ovarian cortex. So, this is a thin cyst not thick like
02:54endometrioma. So, you have to put a good plane and then it should start holding by the grasper
03:04and then you can keep on separating all around equally. Now, once approximately 2-3 centimeter
03:13is a stripped after that to prevent the you know slipping of the cyst you can wrap it over
03:20the grasper and once you wrap it will optimize the traction and as well as it will give you
03:28the better hold and it will not slip. So, this technique is very good to prevent the slipping
03:37of the cystic valve and to get the entire cyst separated from the ovarian cortex although
03:45you have to separate all around equally, but slow wrapping will help you on the left hand
03:52of the instrument and then you can separate the entire cyst with a good plane of dissection.
04:06Again wrap and again separate the ovarian cortex. Ipsy lateral port is required for this technique
04:17and separation is continued. Now, further wrapping and separating the cortex. So, it is done. Now, this is just last part. Again, you can push it above
04:38along the cooper ligament and again you can wrap it. So, it is done. Now, you can disengage it and then just the suction irrigation will
04:46be carried out and any oozing or any bleeding should be taken care of and you should inspect all around the pelvis for any bleeding is not there and after that little
05:00suction irrigation again will be performed and the cystic valve will be taken out just shaking.
05:06And you can see this is clear fluid there is no bleeding two three time irrigation will be performed to check. If there is a bleeding you can take a bite you can suture or you can
05:20use bipolar to do desiccation or mono polar to fulguration, but and now this is the cystic valve. This is 5 mm telescope and with the 10 mm
05:31from glycol port cystic valve is taken out. So, thank you very much for watching this video.
