Which Should Be the Preferred Technique During Laparoscopic Ovarian Cystectomy

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Gynecologic Surgery

Background:

• Ovarian cystectomy is a common gynecologic procedure.
• Hemostasis is crucial after cystectomy to prevent complications.
• Different hemostatic techniques may impact ovarian reserve differently.

Purpose of the Study:

• To compare the long-term effects of hemostatic sutures versus bipolar electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy.
• To evaluate anti-Müllerian hormone (AMH) levels, antral follicle count, and residual ovarian volume.
• To assess pregnancy rates following different hemostatic techniques.

Main Methods:

• Ninety patients with unilateral ovarian cysts underwent laparoscopic stripping cystectomy.
• Patients were randomized into two groups: hemostatic suture or bipolar electrocoagulation for hemostasis.
• Serum AMH, ovarian volume, and antral follicle count were measured preoperatively and at 1, 3, and 12 months postoperatively.

Main Results:

• Hemostatic sutures maintained AMH levels and ovarian volume, showing no significant postoperative decline.
• Bipolar electrocoagulation resulted in significantly lower AMH levels and reduced ovarian volume postoperatively compared to preoperative values.
• No significant difference in pregnancy rates was observed between the two groups.

Conclusions:

• Hemostatic suture is a less destructive method for achieving hemostasis after laparoscopic ovarian cystectomy compared to bipolar electrocoagulation.
• Preservation of ovarian reserve is better with hemostatic sutures.
• Both techniques do not significantly impact long-term pregnancy rates.