Laparoscopic Management of Ovarian Teratoma



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This video demonstrate laparoscopic cystectomy for ovarian teratoma. Germ cell tumours begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma: mature teratoma, which is non cancerous (benign). immature teratoma, which is cancerous. Immature teratomas are usually diagnosed in girls and young women up to their early 20s. These cancers are rare. They are called immature because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage. Keywords: Laparoscopy, Dermoid cyst, Ovarian cyst, Operative laparoscopy. Benign cystic teratomas, or dermoid cysts, are germ cell tumors of the ovary that account for 20-25% of all ovarian tumors and are bilateral in 10-15% of cases. They have a low incidence of malignancy, reported as 1-3%. The majority of dermoid cysts are asymptomatic and are often discovered incidentally upon pelvic exam. The potential for complications such as torsion, spontaneous rupture, risk of chemical peritonitis, and malignancy usually makes surgical treatment necessary upon diagnosis. Traditional therapy for a dermoid cyst has been cystectomy or oophorectomy via laparotomy. The laparoscopic approach has become increasingly accepted since 1989. Because most patients with cystic teratomas are of reproductive age, a conservative approach is ideal; laparoscopy may minimize adhesion formation and thus decrease the chance of compromising fertility. The management of ovarian teratomas in normal conditions is well established, but in rare giant cases (tumor diameter over 15 cm), the choice of management, such as laparotomic or laparoscopic approaches, are controversial and may be therapeutically challenging for surgeons.