OBJECTIVE: To present our experience and patients’ data in the laparoscopic management of benign ovarian teratomas Design: Review of cases of woman with dermoid cysts who underwent laparoscopic surgery in our department from 2000 through 2004 Setting: Department of Obstetrics and Gynecology, School of Medicine, Baskent University, Ankara Patients: 18 women with benign cystic teratomas who underwent laparoscopy Interventions: Laparoscopic oophorectomy or cystectomy by a combination of monopolar cauterization and hydrodissection. Main Outcome Measures: Patient’s age, mean diameter of ovarian mass, preoperative CA-125 level, intraoperative laparoscopic approach, intraoperative spillage rate, intraoperative complications, and histopathologic diagnosis. RESULTS: 13 women underwent laparoscopic cystectomy, and 5 underwent laparoscopic oophorectomy. In cystectomy group, intraoperative spillage of dermoid tissue was occurred in 6 patients (46,1%), while spillage was occurred only in one patient in oophorectomy group (20%). The risk of intraoperative spillage of dermoid tissue was higher when the diameter of cyst more than 5 cm. There were not seen any intraoperative or postoperative complications. No malignancy was reported at postoperative period. CONCLUSION: Laparoscopic approach offers fewer postoperative adhesions, reduced pain, shorter hospital stay, and better cosmetic result. Conservative surgery should be chosen for younger women. However, oophorectomy presents as method of choice for perimenopausal and postmenopausal women, respectively. In order to avoid of the risk of abacterial peritonitis, prophylactic endobag can be used and abdominal cavity should be washed by sodium chloride solution until no fatty particles can be detected in the lavage.

Keywords: intraoperative spillage of dermoid tissue, laparoscopy, mature cystic teratoma, ovarian dermoid cyst