Laparotomy question

[mbcbmom]

I am scheduled to have a laparotomy on Friday and I met the surgeon yesterday.  He said he wants to drain the cyst before removing it.  Is this common?   My Ct-scan showed multioculated cystic mass 13 x 9 x 16.  Septations are delicate but there are solid components.  I just thought they would take it out whole.  Does this sound right?  (Can you tell I don't have much faith in this surgeon?)

[mbcbmom]

Thanks everyone.  I have a pre-op physical tomorrow afternoon so I am going to talk to the person who I see for that plus talk to the dr again before surgery on Friday.  He was ok with removing it intact and I don't mind a bigger incision.  I don't want to risk it of having anything spill when they drain it.  He didn't say anything about bagging it first but he did mention that there was a risk of spilling some of the contents.  His main reason for draining it was to reduce the size so he could get it out of me without making a big incision.  It will be interesting though because I look like I'm pregnant and my abdomen is hard as a rock.  They are planning on removing the cyst and ovary.  If it is malignant they will perform a hysterectomy and appendectomy.  

I will let you know what happens.  Thanks so much for your support.

[SimplyStar]

do not let it be drained unless extra precautions are taken to make sure there is absolutly no spillage.  I hope it is benign, 98% are, but in the rare chance it contains cancer, it is better for the mass to be removed intact, it only taks one loose cancer cell to spread,  My daughters tumor was incapsulated, but even with a lot of precaution, it still had spread, stage 3. They plan on leaving your Ovary?  Very good Luck to you , Marty

[silver&gold]

Hi , I know that when they drain a cyst they bag it first to prevent spilling the contents infact i,ve seen the technique on a utube video.  Take care Angie xx

[hopeshell]

If you are going to have a gyn/onc on call by using this dr. then that seems to be your best option.   It is great they think it is benign.  As far as draining...I think I would opt for the bigger incision and try to remove it complete - however, this dr. may feel he has a better chance of removing it without spreading it by draining it first.  It is a hard call.  But, if he is dr. that works with the gyn/onc on a regular basis then he should know what he is doing.   I'll be praying you have a successful surgery and benign outcome.  Please keep us posted on how you are doing!  It is scary to be facing surgery.  The best thing you can do is make sure you stay on top of the pain  and ask for your meds on a regular basis at first.  The meds work better if they are taken at regular intervals before the pain gets out of control.  This will help you get up and walk and get back to normal sooner.  Please keep us posted on how you are doing.  Best wishes.  Shelly

[mbcbmom]

Hi Shelly,
No, the surgeon I saw was a regular ob/gyn.  I have not seen an gyn/onc but one has reviewed my case and recommended cyst and ovary removal with possible hysterectomy and appendectomy.  My insurance is an hmo and there are only two gyn/onc that support 3 hospitals so they only take cases that really look malignant which mine does not.  I am glad that this cyst is probably benign but as I have learned here you don't really know for sure until they remove it and do the biopsy.  My regular ob/gyn is on medical leave but she had said I could have an gyn/onc do the surgery and put a referral in to the hospital where they are located.  When the other hospital contacted me I was told that I would not be able to have a gyn/onc perform the surgery but if I wanted one to be on call that I could have this other dr do the surgery and that is the one I met the other day.  He said he would remove it without draining it if that is what I wanted but he was just trying to keep me from having such a big incision.

Thanks for your help.  I am going to look into getting a second opinion asap.

[hopeshell]

Hi there,  Is your surgeon a gynecologic oncologist?   If not, you must not proceed without seeing a gyencologic oncologist.  If a general surgeon drains your "cyst" you run the risk of spreading cancer cells if your mass is a malignancy.  Also, you will not have the benefit of being properly staged if it is cancer.  I am a huge believer that you must trust your inner voice and if you are concerned about this surgeon you owe it to yourself to get a second opinion.  I don't know if you are in fact seeing a gyn/onc but I am going to provide this link for you just in case you aren't seeing one and need to locate one in your area:

http://www.wcn.org/interior.cfm?diseaseid=13&featureid=4

There is also a section in this link that lists reasons why it is important to see a gyn/onc.  Just the fact that you have such a large mass and it has solid components is enough for any insurance company to give you approval to have a gyn/onc - even if it means traveling if you don't have one in your town.  

Keep us posted on how is goes.  Good luck to you.    Shelly

[wildbreeze]

I had laproscopic surgery on a 12cm complex cyst with ovary removal last Tuesday (was the 3rd time removing a cyst on this ovary). My Dr. did drain the cyst which significantly reduced the size. He took a bunch of pictures through the scope of the process--looked like he popped a balloon and then took out the leftovers. All went well and I thank God that everything was benign.

[gma718]

I had laparotomy back in May 07...I beleive they took my masses out whole and tested them...thankfully benign! I think the reason my surgeon would not due a laproscopic procedure is because my cyst was large like yours. All I can say is if you are not comfortable with your surgeon seek another opinion...I went to 3 doctors before chosing who I felt the most comfortable with.  Good Luck! Gia :)