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Updated: Oct 11, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Totally Enclosed Protective Device versus Conventional Retrieval Bag in Laparoscopic Ovarian Teratoma Cystectomy: A
Chang Zhou1, Shengdi Hou2, Huan Yu3
1Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, 100029, China; China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Objective:
To evaluate a "Totally Enclosed Protective Device" in preventing macroscopic intraoperative leakage during laparoscopic ovarian cystectomy compared to conventional methods.
Design:
Prospective, multicenter, randomized controlled superiority trial (1:1).
Setting:
Four academic medical centers in Beijing, China.
Participants:
119 premenopausal women (18-45 years) scheduled for laparoscopic cystectomy for unilateral ovarian masses (3-10 cm) were randomized. After exclusions, 105 participants (intervention: 53; control: 52) were analyzed.
Interventions:
Laparoscopic cystectomy using the device for contained decortication/extraction, versus conventional decortication followed by standard retrieval bag extraction.
Measurements And Main Results:
Device deployment success was 100%. Macroscopic leakage (primary outcome) was significantly lower in the intervention group (0.0%, 0/53) than controls (25.0%, 13/52) (risk difference [RD], -25.0%; 95% CI, -36.8% to -13.2%; P<0.001). Intraoperative rupture rates were comparable (32.1% vs. 25.0%; RD, 7.1%; 95% CI, -10.3% to 24.5%; P=0.422). Operative times were similar. Over a 34.5-month median follow-up, 5 control patients (9.6%) developed new-onset chronic pelvic pain, versus 0 in the intervention group.
Conclusion:
Within this study cohort, the device provided an effective physical barrier, and no macroscopic intraoperative spillage was observed. Preliminary findings suggest that standardizing this contained extraction strategy is associated with the absence of long-term complications, specifically chronic pelvic pain, in this sample.
Funding:
This study was supported by Capital's Funds for Health Improvement and Research (No. 2022-2-406).
Clinical Trial Registration:
Registration Number: NCT04406597; Date of Registration: May 20, 2022.
