Laparoscopic management of large ovarian tumors: Clinical tips for overcoming common concerns

Aim: This study was performed to assess the feasibility and efficacy of laparoscopic management for patients with large ovarian tumors. Material and Methods: A retrospective analysis was performed of the medical records of 52 women who underwent laparoscopic surgery for large ovarian tumors whose maximum diameter was ≥15 cm and a low possibility of malignancy. Results: The median age of patients was 35 years (range 18-84), median body mass index was 22.4 kg/m ² (range 12.4-31.5) and 18 patients had previous operative history. The median tumor diameter was 17 cm (range 15-40). There were no conversions to laparotomy and perioperative complications. The median operating time, estimated blood loss, and hospital stay were 80 min (range 25-225), 100 mL (range 50-500) and 3 days (range 2-14), respectively. The operative procedures performed were salpingo-oophorectomy (n = 26), ovarian cystectomy (n = 16), laparoscopically assisted vaginal hysterectomy with unilateral or bilateral salpingooophorectomy (n = 9), and laparoscopically assisted staging surgery (n = 1). The histopathological results were mucinous cystadenoma (n = 25), mature cystic teratoma (n = 9), serous cystadenoma (n = 6), endometrioma (n = 5), mucinous borderline tumor (n = 4), follicular cyst (n = 2), and clear cell carcinoma (n = 1). Conclusion: Laparoscopic management of large ovarian tumors is feasible and efficient with appropriate patient selection and experience of surgeons.