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Ovarian drilling, also known as multiperforation or laparoscopic ovarian diathermy, is a surgical technique of puncturing the membranes surrounding the ovary with a laser beam or a surgical needle using minimally invasive laparoscopic procedures. [1] It differs from ovarian wedge resection, which involves the cutting of tissue.
Partial oophorectomy (i.e., ovarian cyst removal not involving total oophorectomy) is often used to treat milder cases of endometriosis when non-surgical hormonal treatments fail to stop cyst formation. Removal of ovarian cysts through partial oophorectomy is also used to treat extreme pelvic pain from chronic hormonal-related pelvic problems.
There are four types of ovarian cysts — functional cysts, PCOS cysts, benign ovarian tumor and malignant ovarian tumor — that range from harmless to fatal.
Ovarian cysts may be classified according to whether they are a variant of the normal menstrual cycle, referred to as a functional or follicular cyst. [6] Ovarian cysts are considered large when they are over 5 cm and giant when they are over 15 cm. In children, ovarian cysts reaching above the level of the umbilicus are considered giant.
Trehan's temporary ovarian suspension, a technique in which the ovaries are suspended for a week after surgery, may be used to reduce the incidence of adhesions after endometriosis surgery. [ 149 ] [ 150 ] Removal of cysts on the ovary without removing the ovary is a safe procedure.
For example, vaginal natural orifice transluminal endoscopic surgery (vNOTES) is a new innovative approach that has been used for ovarian torsion, tubal ectopic pregnancy, and ovarian cystectomies. [10] This surgical approach is minimally invasive and has emerged in an effort to reduce pain, risks, and potential for scarring. [12]
The mainstay of treatment is surgery to remove the residual ovarian tissue. Women with ORS with a pelvic mass should have appropriate evaluation for malignancy . Hormonal therapy to suppress ovarian function is an alternative treatment for those who refuse surgery, or those who are not candidates for surgery. [3]
Theca lutein cyst is a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. These cysts result from exaggerated physiological stimulation (hyperreactio luteinalis) due to elevated levels of beta- human chorionic gonadotropin (beta-hCG) or hypersensitivity to beta-hCG.
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