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/m2 (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 salpingo‐oophorectomy (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.