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Updated: Jun 11, 2025
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Comparative Analysis of Electrosurgical Energy and Hemostatic Sealant for Hemostasis in Laparoscopic Ovarian
Ok-Ju Kang1, Joo-Hyun Nam1, Jeong-Yeol Park1
1Department of Obstetrics & Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (all authors).
Study Objective:
To evaluate the efficacy of hemostatic sealant versus electrosurgical energy in achieving hemostasis and preserving postoperative ovarian reserve during laparoscopic ovarian cystectomy.
Design:
Randomized controlled trial.
Setting:
Single-center study.
Patients:
A total of 121 patients undergoing laparoscopic ovarian cystectomy.
Interventions:
Patients were randomized to receive either hemostatic sealant or electrosurgical energy for hemostasis during surgery.
Measurements And Main Results:
The primary outcome measured was the time required to achieve hemostasis. Secondary outcomes included operating time, estimated blood loss, and assessment of postoperative ovarian reserve through hormone levels (anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], E2, inhibin) at three follow-up intervals. The results showed comparable hemostasis times between the two groups. Postoperative hormone levels indicated no significant differences in the impact on ovarian reserve between the groups, except in cases of bilateral ovarian cystectomy, where the hemostatic sealant group exhibited a lesser decline in AMH levels.
Conclusion:
Both hemostatic sealant and electrosurgical energy showed equivalent effectiveness in achieving hemostasis during laparoscopic ovarian cystectomy, with comparable results in hemostasis time, blood loss, postoperative complications, and ovarian reserve preservation. However, in cases of bilateral ovarian cystectomy, the hemostatic sealant group exhibited a lesser decline in AMH levels, suggesting a potential advantage in preserving ovarian reserve in these specific cases.
