Management of unexpected ovarian dermoid cyst during laparoscopy for oocyte pickup

In conclusion, management of unexpected SDT during OPU include the following therapeutic goals: (1) complete eradication of the tumor to eliminate the remote possibility of malignancy and recurrence; (2) performance of adequate peritoneal lavage to prevent chemical peritonitis; (3) conservation of the maximum amount of functional ovarian tissue; and (4) exclusion of the possibility of dermoid cyst in the contralateral ovary. If laparoscopic drainage of a SDT, marsupialization, and adequate fulguration of cystic wall provide a low incidence of recurrence, the risk of oophorectomy and the necessity of laparotomy will be avoided. The aspirate contents should be examined and histopathologic confirmation of the clinical diagnosis and exclusion of a malignant process should always be performed. The laparoscopic approach must be investigated further to determine its efficacy compared with the conventional approach.