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Can laparoscopy at best preserve the ovarian tissue that can be preserv...
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Can laparoscopy at best preserve the ovarian tissue that can be preserved otherwise by laparotomy?


Thanks a lot for the wonderful women on this forum. I got help and finally went through the surgery of removing the teratoma. I will write down the whole process and the recovery experience later on soon as a reference added into this forum; actually, almost same as previous posts on recovery.

Me: 30+ yrs, no children. Teratomas on the both sides: one 7x6x7cm, one 2x2cm

Here I want to discuss the advantages and disadvantages of laparoscopy and laparotomy.
My surgeon chose the laparotomy for me. He once mentioned the reason that the teratoma has a big size (7x6x7cm, and the diagonal length would be longer, depending on how you measure it). Before the surgery, I was afraid I might mislead my doctor, so I did not discuss more on what surgery to adopt with him. I just emphasized that I hoped to preserve the ovaries and I did not care about scars and I could recover soon since I am healthy overall.

After the surgery, I kept googling online. There are many clinic papers on comparison between laparoscopy and laparotomy. (search on Google by the keywords: comparison between laparosocpy laparotomy ovarian cyst)
Disadvantages of laparosocpy:
(1) Higher possibility of intraoperative rupture of a dermoid cyst.
(2) Recurrence may be more frequent after cystectomy performed by laparoscopy than by laparotomy.
(3) Another  disadvantage I worried most about with laparosocpy is the extent to preserve the normal ovarian tissue. Although one small part of the ovary can function well, if the remaining ovary has cysts re-grow inside, a smaller ovary has a smaller chance to get preserved for the second or third surgeries. So it is better to always preserver more ovarian tissue as possible.
From the video below, it seems one half normal ovarian tissue is removed. I guess it might be due to inconvenience of manipulation of laparoscopy. But since I am not a professional, anyone’s new opinion on this?
http://www.youtube.com/watch?v=NbCVFKV1JzU&feature=related
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