Leak-proof extracorporeal drainage for management of large ovarian tumors

To describe our experience with leak-proof extracorporeal drainage through a minilaparotomy for management of large ovarian tumors.

Twenty patients who had presumed benign ovarian tumors larger than 10 cm were selected to undergo this technique. A 4 cm skin incision was made transversely above the symphysis pubis. After application of a self-retaining wound retractor, a polyurethane membrane was firmly affixed to the tumor surface by 2-octylcyanoacrylate adhesive. Most cyst contents were aspirated by a suction tube and the deflated ovary was exteriorized and excised extracorporeally.

The median age and median BMI of the patients were 34 years and 23.2, respectively. The maximum tumor diameter varied from 10 to 26 cm (median 15 cm). This technique was successfully administered to 18 patients. The incision was extended to 7 cm in the most obese patient. The procedure was converted to a laparotomy in one patient with severe pelvic adhesion. The median aspiration volume was 800 mL and the median operative time was 80 min. There was no intra-abdominal leakage of tumor contents in all patients. The procedure was converted to laparoscopic fertility-preserving staging operation in two patients with borderline ovarian tumors. The other pathologic diagnoses were six mucinous cystadenomas, six dermoid cysts, three serous cystadenomas, one simple cyst, one corpus luteal cyst, and one endometrioma.

Minilaparotomy with leak-proof extracorporeal drainage using cyanoacrylate adhesive and polyurethane membrane is reliable, safe, and feasible for management of large ovarian tumors with low probability of malignancy in selected patients.