Laparoscopic Port Site Dermoid Cyst : A Rare And Unusual Pre
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Here presents a case reports published in The journal of minimally invasive gynecology, A 36 year old, P2L2 with complaints of lower abdominal pain for 6-7 months. She had no other associated complaints. She had undergone laparoscopic surgery for right dermoid cyst 5 years back. On examination, her vital parameters and systemic examination was unremarkable. There was minimal tenderness noted at the previous laparoscopic scar site in the right iliac fossa.

Ultrasonography revealed a right ovarian complex cyst of 4 × 5cm suggestive of dermoid cyst and a 5cm complex mass in the right iliac fossa in the anterior abdominal wall. She was posted for a laparoscopic surgery after thorough counselling. On laparoscopy, a right ovarian mass of approximately 5cm was noted with few tubo-ovarian adhesions (Figure 1). An encapsulated mass of around 5cm was noted on the right anterior abdominal wall (Figure 2).

Salpingo-oophorectomy was performed with bipolar and scissor to prevent recurrence. The anterior abdominal mass seemed encapsulated under the parietal peritoneum. The capsule was incised with scissors, sebaceous material was seen . The rest of the mass was removed carefully without spillage. A urosac bag was then introduced through one of the accessory ports to avoid spillage while retrieval .Histopathology was consistent with findings of a mature cystic teratoma.

The retrieval of the cyst is a challenge in laparoscopy . The use of an impermeable retrieval bag is very crucial . Most centers in India prefer using a surgical glove bag owing to the cost effectivity. However, they have poor tensile strength. The urosac bag is utilized, commonly used otherwise in bladder catherization. It is thick and impermeable and can be easily introduced by rolling it upon itself. The cyst can then be retrieved rather safely without the scare of inadvertent spillage.

Source: https://www.jmig.org/article/S1553-4650(20)30115-1/fulltext
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