Abdominal vs. laparoscopic surgery

At 63, I have been told that I need my ovaries removed because of potential ovarian cancer(50/50 chance). There is a large complex cyst (adnexal w/ no hydronephrosis) in my left ovary which has been watched for 5 years. It is a mass mostly cystic w/ a peripheral solid nodule that measure approximately 8 mm in size. It contains punctate internal calcification. Foci of calcification is also noted w/in the wall of the cyst. The appearance suggests a cystic ovarian neoplasm such as a cystadenoma, not typical for a dermoid. There is no free fluid.

There has been a question about my uterus which has some fluid trapped at the fundus, an intracavitary stripe, and a polyp or fibroid.

There is no question that I have to have the ovaries out, since the cyst has suddenly started to grow slightly after being atable for 5 years. However my question concerns the type of procedure. Dr.1 feels as if I can have the ovaries removed laparoscopically, while leaving the uterus, and going in, right then, abdominally if it's cancer, while Dr.2 wants to remove ovaries and uterus abdominally from the start.

The concern is that I had a lacunar infarct (stroke)after dental surgery 7 years ago. Dr.2 doesn't want to put me through two operations, whereas Dr.1 feels that, since the cyst might be benign, I can start off w/ the laparoscope and then do it abdominally if it's cancer. At the same time I would have a D&C, wait a week for the pathologist's report and go back for surgery.

Why can't the uterus be removed w/ the laparoscope as well? Must this surgery be done abdominally?

[dana anne]

There is no question that I have to have the ovaries out, since the cyst has suddenly started to grow slightly after being atable for 5 years. However my question concerns the type of procedure. Dr.1 feels as if I can have the ovaries removed laparoscopically, while leaving the uterus, and going in, right then, abdominally if it's cancer, while Dr.2 wants to remove ovaries and uterus abdominally from the start.

The concern is that I had a lacunar infarct (stroke)after dental surgery 7 years ago. Dr.2 doesn't want to put me through two operations, whereas Dr.1 feels that, since the cyst might be benign, I can start off w/ the laparoscope and then do it abdominally if it's cancer. At the same time I would have a D&C, wait a week for the pathologist's report and go back for surgery.

Why can't the uterus be removed w/ the laparoscope as well? Must this surgery be done abdominally?

I think id go with DR 2.  Id research this topic online.  These are good questions.  Based on your age and your previous stroke i would opt for one surgery.  The uterus may be removed with the laparascope i think but the idea is not to spill any contents of the cyst into the abdomen if its cancer.  So the laparotomy may be the safest route so the Doc has more room to take things out.