ROMA (ITALPRESS) – A giant ovarian cyst, weighing 7 kilos and the size of 33 cm, which almost entirely occupied the abdomen of a 16-year-old girl, was successfully removed to the Child Jesus Hospital. The exceptional intervention was carried out at the headquarters of Palidoro by the team of Andrological Surgery using an innovative hybrid technique between traditional and minimal surgery. The procedure has allowed to completely remove the mass avoiding the dispersion of its content in the abdomen, to preserve the healthy ovarian tissue, to minimize the invasiveness and to minimize the aesthetic impact of the intervention. “This has been possible thanks to the collaboration between surgeons, anesthetists and nursing staff and the experience gained by our Hospital in managing the most difficult cases and state-of-the-art surgical paths,” explains Massimiliano Silveri, head of the Simple Operational Unit of Andrological Surgery of the Child Jesus. The gigantic cystic formation occupied much of the abdominal cavity. It measured 33 for 18 cm, had a total weight of about 7 kilos and contained over 6 liters of liquid. The size of the mass compressed the abdominal organs, with the risk of progressively compromising its functionality. The removal of the cyst, moreover, had to be performed preserving the healthy fabric of the ovary and therefore the future fertility of the girl.
The histological examination carried out after the intervention identified the formation as a serum cystoadenoma, a benign tumor of the ovary. Before the operation, however, it was not possible to know with certainty the nature of the mass. It was therefore necessary to adopt all the precautions envisaged in the presence of a possible tumor pathology, avoiding in particular the release of the contents of the cyst in the abdominal cavity. The exceptional size of the mass made the use of conventional surgical techniques particularly complex. In fact, the cyst occupied almost entirely the abdomen and did not allow, at the initial stage of the intervention, to create the necessary space to operate in laparoscopy. The team of the Child Jesus therefore used a hybrid procedure, combining traditional and mini-nvasive surgery. Through a small incision of just 5 centimeters at the bottom of the abdomen, similar to that used for a cesarean cut, the surgeons initially isolated the cyst creating a protected and tight area – a sort of stagnatory chamber – to avoid any dispersion of its content. A part of the liquid was then aspired slowly and controlledly, gradually reducing the volume of the mass. A gradual emptying was necessary to allow the abdominal organs, long compressed by cysts, to adapt to the freed space and to avoid dangerous changes in blood pressure and circulation.
The reduction of the volume of the mass allowed to create in the abdomen the space necessary to continue the intervention in laparoscopy, with the help of a camera, and identify the origin of the cyst from the left ovary. “In such a young patient it was particularly important to minimize the aesthetic impact of the intervention,” explains Lorna Spagnol, the surgeon of the Child Jesus who performed the operation. “Thanks to the technique used it was possible to remove a cyst of exceptional dimensions through an engraving of just 5 cm, limiting the physical consequences and the possible psychological impact of a much larger scar.” After the laparoscopic phase, the cyst was further emptied and the residual part of the formation was carried out and removed through the same engraving of 5 cm. The intervention, which lasted about 2 hours, was performed by doctor Lorna Spagnol and Ilaria Buconi, under the supervision of Dr. Massimiliano Silveri, and involved the team of Anesthesia and Reanimation and the nursing staff of the operating sector of the headquarters of Palidoro. The girl had a rapid postoperative recovery and was released in good health conditions just four days after surgery.
– photo print office Child Jesus –
(ITALPRESS).
