Laparoskopi pada Kista Ovarium

Source: OAI

ABSTRACT mkn-sep2005- (10) Kista ovarium fisiologis merupakan massa di ovarium yang paling umum ditemukan. Kista ini disebabkan oleh karena kegagalan folikel untuk pecah atau regresi. Ukuran kista ovarium fisiologis ini kurang dari 6 cm, permukaan rata, mobile dan konsistensi kistik. Keluhan dapat berupa massa di daerah pelvik maupun ketidakteraturan haid. Terdapat beberapa jenis kista fungsional yaitu kista folikuler, kista korpus luteum, kista teka lutein dan luteoma kehamilan. Penanganan kista ovarium dapat berupa konservatif maupun operatif. Prosedur pembedahan perlu dilakukan untuk mengetahui asal massa bila dari pemeriksaan klinis dan pemeriksaan penunjang sulit menentukan asal massa tersebut.Pada tahun 1991, laparoskopi baru digunakan baik sebagai alat diagnosa sekaligus sebagai terapi. Prosedur pembedahan kista ovarium ini dapat berupa kistektomi dan salfingo-ooforektomi. Kelebihan dari tindakan laparoskopi adalah trauma pada dinding abdomen dan resiko perlengketan lebih minimal, waktu operasi lebih singkat dan masa penyembuhan yang lebih cepat dibanding dengan laparotomi. Physiologic ovarium cyst is the most common mass in the ovarium. The cyst is caused by the failure of the follicle to breakdown or regression. The size of the physiologic ovarium cyst is less than 6 cm, with smooth surface, mobile and cystic consistency. The sign can be found the mass in the pelvic area or irregular menstruation. There are several type of functional cyst which are follicular, luteum corpus cyst, teccalutein cyst, and luteoma pregnancy. Management of ovarium cyst can be conservative or operative. We need to do the surgery procedure to investigate the root of the mass. In 1991, laparoscopy just newly used as a diagnosed tool and also as a therapy. Surgery procedure of this ovarium cyst can be cystectomy and also salphingo-ooforectomy. The advantage of laparoscopy is minimalization trauma in the abdominal wall and the risk of adhesion, shorter operation time and quicker healing time than laparatomy.

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    ABSTRACT: To review recent literature on the laparoscopic management of adnexal masses, when this approach may be considered as a gold standard. Cyst rupture was recently demonstrated to be a significant prognostic factor in stage I invasive epithelial carcinoma, and it was recommended to restrict the laparoscopic approach to patients with preoperative evidence that the cyst was benign. The laparoscopic approach is still highly controversial in masses suspicious at ultrasound. The limits of the laparoscopic approach are discussed reviewing recent literature and our experience. The laparoscopic management of adnexal masses appears to be safe in most hospitals even in developing countries. This approach is being used with increasing frequency in unusual indications such as newborns, children, adolescents and pregnant women. The learning curve for endoscopic surgery appears to be longer than expected. Many patients with benign adnexal masses, such as ovarian endometrioma, are still treated by laparotomy or with an inadequate endoscopic technique. Several studies have suggested that the stripping technique is a tissue-sparing procedure. The laparoscopic puncture of malignant ovarian tumours confined to the ovaries is uncommon, and should be avoided whenever possible. The teaching of endoscopy is essential to promote adequate procedures performed according to the principles of microsurgery and to preserve postoperative ovarian physiology.
    Current Opinion in Obstetrics and Gynecology 09/2002; 14(4):423-8. DOI:10.1097/00001703-200208000-00010 · 2.37 Impact Factor
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    ABSTRACT: Retrospective study of 121 cases of adnexal masses which were managed laparoscopically was carried out. The aim of study was to evaluate the safety and effectiveness of laparoscopic management of adnexal masses. In 120 cases, procedure was completed safely with minimum morbidity. In one case laparotomy had to be done to complete the procedure. In 76 cases cystectomy was done, 26 required salpingo-oophorectomy and 19 required only salpingectomy. Histologic evaluation revealed 30 functional cysts, 36 endometriotic cysts, 11 dermoids, 9 serous cystadenomas, 3 mucinous cystadenomas, 11 parovarian cysts, 19 cases of hydrosalpinx and 2 cases of tuberculosis.
  • Surgery for benign disease of the ovary In: Te Linde's Operative Gynecology, Rock JA, Thompson JD editors. Lippincott-Raven Publishers, Philadelphia, 1997. p 625 – 44. 3. Audlbert AJM. Laparoscopic ovarian surgery and ovarian torsion Endoscopic surgery for gynecologists. . 1993. WB Saunders Tulandi T. Ovarian cystectomy. Gynecol Endosc 4 134-4159.


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