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Management of ovarian dermoids without laparoscopy or laparotomy
1Breach Candy Hospital & Research Centre and Sir Hurkisondas Narottamdas Hospital, Mumbai, India. silsal@bom2.vsnl.net.in
Objective:
To report experience of managing ovarian dermoids via the vaginal route.
Study Design:
A series of 26 cases managed this way either with or without hysterectomy and for comparison 10 women managed by laparotomy and 6 who underwent laparoscopic ovarian cystectomy or oophorectomy were considered.
Results:
The vaginal approach was successful in all patients, without need for laparoscopic assistance or a switch over to laparotomy. Spill was minimal or absent in the vaginal group and recovery significantly faster in the vaginal and laparoscopic groups compared to the laparotomy group. Hospital stay was slightly shorter in the vaginal than the laparoscopic group. No disposable material or equipment was used in the vaginal or laparotomy group.
Conclusion:
For mobile, benign ovarian teratoma, the vaginal route should be strongly considered to minimise invasive surgery, particularly when the operator is an experienced vaginal surgeon or laparoscopic equipment or laparoscopic surgeons are not easily available. Reduced spillage and speedier recovery are important advantages.