Keyhole vs Bikini Cut vs Vertical Laparotomy incision for HUGE Ovarian cyst?

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Im 19 yrs old and I think I have the hugest ovarian cyst compared to anyone else online at my age sad The ultrasound and CT Scan with contrast reports state it is 23-25 x 18 cm (yikes!), with "slightly turbid fluid" (this makes me worried because it sounds mucousal but the doctors keep saying its fluid), and that it is benign and simple, originating from my left ovary, with no septations (although one doctor thinks there is one by looking at the CT scan). Its putting pressure on my kidneys and even pushing the diaphram.

Anyways, I visited both a gyn/onc and a gyn. The gyn/onc said the only way he would go about this is a vertical incision from the belly button downwards, and might even need to extend further above in order to remove the entire cyst and provide proper staging (just in case).

The other dr is a gyn, she says she can do both a laporoscopy (to aspartate and drain the fluid then remove the cyst from another small cut) or a "bikini cut" pfannenstiel incision. 

Im not sure about the laporoscopy because Im afraid the cyst is mucinous and would spill or something and dont feel comfortable about it. And the gyn/onc surgery sounds way too aggressive... this leaves me with the bikini line cut.

My question is- does it really sound like a good idea? She says she's removed cysts that way but not one as big as mine. Obviously during the operation if she ends up having to, then she will do a vertical incision (with a signed consent prior). But from your experiences or what you've heard from others - would the pfannenstiel incision actually be enough, with no complications, or should I not hold high expectations? 


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  • Posted

    Hi dana07040, I completely understand your fears on this. I was just released from the hospital this past Monday after having an ovarian cyst, that I had no idea I had, removed. And like you, mine was abnormally large as well, and being turned into a case study now at the hospital I was in. I am 17 years old and a type 1 diabetic. My cyst was so large it nearly landed me in a diabetic coma from the stress it was putting my body into. All of my internal organs were compressed into a 3-3 1/2 in. pocket and I had immense pressure on my bladder and lungs. It was wrapped around a fallopian tube, which had to be removed as well as a good 1/2 of my ovaries. The surgeon went through my belly button first and removed two 2 liters worth of fluid from the mass, she then proceeded to make a 5in cut below my belly button and removed the rest of the cyst. Even after they had drained it, it was still 16in long and 14in wide. I'm not going to lie to you, the healing process is rough and at times very painful and frustrating, but I feel it was the best way to go about it. I think that when they go down from the belly they are able to make the smallest cut necessary.  I hope all goes well for you! I know that it is nerve wrecking to think about going into surgery, I've went under 5 times now for one thing or another and I don't think I have ever been as scared as I was 2 weeks ago. Which is silly because the 1st 4 surgeries I had were on my head! Lol! I wish you the best, and God blesssmile
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    • Posted

      Hi ainsle I just left the hospital thinking I had it rough but WOW youre brave! I eventually went for the bikini cut incision, 5 cm and they removed almost 3 litres worth of fluid. I even saw some pictures of the actual cyst and cant help but feel grossed out whenever I remember them. And yeah I feel you its really tough, It hurts like hell to laugh or cough or sneeze haha sad I think we should get an abdominal belt or belly binder or something.

      Thanks a lot for sharing! Wishing you a speedy recovery Xx

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  • Posted

    I have a 35cm cyst (or bigger, they aren't sure as it's too big to track properly) and have been told I'm having a vertical laparotomy. The cut will probably extend above my belly button. I was told this was my best option and I agree. The recovery may take longer and be more painful but it's the safest way for them to remove the cyst and make any further decisions about what else to remove (I'm giving full permission for a hysterectomy but they will avoid if possible due to my age, 33). 

    Talk to them again and voice your concerns. They don't do laparotomy's unless they absolutely have to.

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    • Posted

      Hi carla! I just had the horizontal bikini incision and its really tough but not as bad as I thought it would be - hopefully yours is too! Let us know how it goes and good luck Xx
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