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18 cm huge ovarian tumour removed by laparoscopy at Laparoscopy Hospital, New Delhi

By: Dr. Sadhana

Laparoscopic management of early ovarian cancer is safe and effective and survival outcome is acceptable. At Laparoscopy Hospital, New Delhi Laparoscopic management of malignant ovarian tumour was performed for a Nigerian patient on 30th of August 2008. This giant ovarian tumors can be safely removed laparoscopically only by experienced laparoscopic surgeons. According to Prof. Dr. R.K. Mishra, Director, Laparoscopy Hospital, the laparoscopic removal of giant ovarian tumors in patient’s is preferable to removal by laparotomy. Surgical procedures for these malignant tumors of the ovary can be performed by open surgery (laparotomy) or keyhole surgery (laparoscopy) techniques. Historically, open surgery has been used, but new keyhole surgery seems attractive in that it appears to require a shorter hospital stay and there is a quicker return to normal activities for women.

The patient Mrs. Benedette I. Nwoye-Okorie With her husband came from Nigeria to laparoscopy Hospital, New Delhi to get operated for this disease. She was having raised CA 125 marker and deranged hormonal essay. The CT findings were also towards the malignant change. One of the big proglem in dealing with the big tumour size is extraction of the tissue which is extremely difficult. The good quality commercially available endo-bag is required to extract the tumour without the risk of metastasis.

The use of morcellator is also not possible in these cases because of risk of metastasis in other part of body. For extraction of the tumour of this patient Lap disc was used. This a hand port used to prevent metastasis

The practice of laparoscopic surgery for ovarian tumour is associated with benefits and harms. The minimal access surgical management of ovarian tumours is similar to that of open surgery. The procedures include resection of the tumour (enucleation), removal of an ovary or ovaries (oophorectomy), or surgical excision of the fallopian tube and ovary (salpingo-oophorectomy). The procedure can be done by open surgery (laparotomy) or keyhole surgery (laparoscopy) technique.

The benefits of laparoscopic surgery include shorter hospital stay, earlier return to normal activity, and reduced postoperative pain. However, conventional laparoscopic surgery techniques required the infusion of gas carbon dioxide in the peritoneum to distend the abdomen and displace the bowel upward to create the room for surgical manipulation. Serious complications such as abnormally high levels of carbon dioxide in the circulating blood (hypercarbia) and perforation of internal organs have also been reported. These serious complications may be harmful to the patients especially if she is terminally ill.

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