Experienced laparoscopic surgeons should consider laparoscopy as an alternative to
laparotomy in management of ovarian
dermoid cysts in selected cases. The aim of this study was to analyze the safety of laparoscopy in ovarian
dermoid cysts treatment and risk of chemical
peritonitis. We report 63 cases of patients (mean age of 37) with ovarian
dermoid cysts originating from the ovary, treated from 2002 to 2010. Most of the patients underwent
cysts removal. In 7 patients
salpingo-oophorectomy was performed. We used 15 mm
trocars for removing specimens. In patients with
dermoid cyst rupture peritoneal cavity was washed out thoroughly with Ringer
lactate and drained for 24-48 hours. All the material extracted was sent for a histopathology examination. The diagnosis of mature ovarian
dermoid cysts was confirmed in 58 (92.63%) of cases and immature ovarian
dermoid cysts in 5 (7.37%) cases.
Dermoid cysts were composed of tissue developed from three germinative layers in 31 (49%) patients, from two germinative layers in 25 (40%), and in 7 (11%) patients from one germinative layer. No intra or postoperative complications occurred. No signs or symptoms of chemical
peritonitis were observed regardless of cystic spillage or not. We conclude that the risk of chemical
peritonitis can be minimized when undertaking laparoscopic removal of ovarian
dermoid cysts if the peritoneal cavity is washed out thoroughly from spillage of
cyst contents. Drainage of peritoneal cavity should be performed in the patients with the ruptured
dermoid cysts.