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Ovarian Cancer (Expert Forum)
Laparoscopy or Laparotomy?
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center
Boston - MA
This forum is for questions and support regarding ovarian cancer issues, such as: Biopsy, Chemotherapy, Clinical Trials, Genetics, Hysterectomy,Immunotherapy, Ovarian Cancer Types, Radiation Therapy, Risk Factors, Screening, Staging, Surgery.
Laparoscopy or Laparotomy?
by aydee, Nov 03, 2006 12:00AM
Hi
As said before, I have what appear on the TVU to be simple cysts on both ovaries. The right ovary was enlarged last December at 4cm, in June at 6.75cm. CA125 68 in September, 81 in October. Laparotomy scheduled for next week to remove cyst and probably ovary.
Now, after a year of constipation and diarrhoea, suddenly I feel fine! I am still a bit bloated but I feel well. I don't feel 'there is something wrong'. (One thing I do feel is that I 'lurch' when I stand up - not dizzy just as if the balance of my weight is different from what I would expect)
Is it possible that the cyst has burst / gone? I did have very bad pains in August that went with antibiotics. My consultant says that when cysts get to that size they rarely resolve themselves. Do you think it would be worth asking the surgeon to start with a laparoscopy and only proceed with a full laparotomy if he sees anything (if possible)? Or does my rising CA125 level warrant full investigation anyway?
Sorry for so many questions, thank you so much for any further help and advice you can give me.
Aydee
As said before, I have what appear on the TVU to be simple cysts on both ovaries. The right ovary was enlarged last December at 4cm, in June at 6.75cm. CA125 68 in September, 81 in October. Laparotomy scheduled for next week to remove cyst and probably ovary.
Now, after a year of constipation and diarrhoea, suddenly I feel fine! I am still a bit bloated but I feel well. I don't feel 'there is something wrong'. (One thing I do feel is that I 'lurch' when I stand up - not dizzy just as if the balance of my weight is different from what I would expect)
Is it possible that the cyst has burst / gone? I did have very bad pains in August that went with antibiotics. My consultant says that when cysts get to that size they rarely resolve themselves. Do you think it would be worth asking the surgeon to start with a laparoscopy and only proceed with a full laparotomy if he sees anything (if possible)? Or does my rising CA125 level warrant full investigation anyway?
Sorry for so many questions, thank you so much for any further help and advice you can give me.
Aydee
Doctor's Answer
by Annekathryn Goodman, M.D., Nov 05, 2006 12:00AM
, Nov 05, 2006 12:00AM
Hi Aydee,
You have good questions.
I would suggest asking your doc if you can get another ultrasound before surgery. If the cysts are completely gone, then you should talk to your surgeon about the need for surgery. If the cysts are still present, then it is really the surgeon's decision about which surgical approach is best.
A decision about laparoscopy versus laparotomy will depend on many factors including, size of the cysts, the complexity of the cysts, history of previous abdominal surgery. Finally at the time of surgery, most surgeons would perform a pelvic examination before making an incision. This is very helpful to decide on the type of incision. If one feels a large mass and nodularity, one would definitely consider a laparotomy. On the other hand, if the cyst is small and mobile (is not stuck), a laparoscopy is a reasonable option.
best wishes
You have good questions.
I would suggest asking your doc if you can get another ultrasound before surgery. If the cysts are completely gone, then you should talk to your surgeon about the need for surgery. If the cysts are still present, then it is really the surgeon's decision about which surgical approach is best.
A decision about laparoscopy versus laparotomy will depend on many factors including, size of the cysts, the complexity of the cysts, history of previous abdominal surgery. Finally at the time of surgery, most surgeons would perform a pelvic examination before making an incision. This is very helpful to decide on the type of incision. If one feels a large mass and nodularity, one would definitely consider a laparotomy. On the other hand, if the cyst is small and mobile (is not stuck), a laparoscopy is a reasonable option.
best wishes
Member Comments (2)
by worriedtr, Nov 07, 2006 12:00AM
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