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Updated: Aug 18, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Laparoscopic management of ovarian remnant
Ceana Nezhat1, Susan Kearney, Shazia Malik
1Center for Special Pelvic Surgery, 5555 Peachtree Dunwoody Road, Suite 276, Atlanta, GA 30342, USA. info@Nezhat.com
Objective:
To report outcomes of laparoscopic management of patients with ovarian remnant (OR).
Design:
Retrospective chart review.
Setting:
Referral practice and tertiary medical center.
Patient(S):
Sixty-four patients with confirmed OR who underwent laparoscopic treatment between July 1989 and September 2003.
Intervention(S):
Laparoscopic excision of OR.
Main Outcome Measure(S):
Technical feasibility and recurrence.
Result(S):
Sixty-nine laparoscopies were performed to remove ovarian remnants, with five patients requiring two laparoscopies. Two cases were converted to laparotomy and one to mini-laparotomy for bowel resection. In 64% (41 out of 64), pelvic mass was diagnosed by imaging (35 by ultrasound, 5 by computerized tomography [CT], and 1 by both). The majority of ovarian remnants were found attached to one or more of the following: ureter, bowel, pelvic sidewall, bladder, rectum, and uterosacral ligament. Intraoperative complications occurred in four cases: three enterotomy and repair; one cystotomy and repair. Twelve minor postoperative complications occurred including urinary tract infection, hematuria, umbilical incision infection, and transient tachycardia. Three major postoperative complications occurred: one umbilical omental hernia, one wound abscess requiring operation, and one vesicovaginal fistula. Adhesions were present in all cases, endometriosis in 55% (35 out of 64), and fibrosis in 30% (19 out of 64).
Conclusion(S):
In experienced hands, laparoscopic treatment of OR results in acceptable outcomes with its associated advantages over laparotomy.
