[Is it necessary to operate on every ovarian cyst?]

In the absence of a prospective study comparing the complications in a series of patients with operated and non-operated ovarian cyst, all ovarian tumours must be operated and examined histologically. Apart from ultrasound-guided aspiration, which may be proposed as sole treatment under very strictly defined conditions, laparoscopic surgery has transformed the treatment of ovarian cysts. The first difficulty is to eliminate malignant or borderline lesions which require classical treatment via laparotomy. The second difficulty consists of avoiding any peritoneal and parietal dissemination. Dissection of the closed cyst, occasionally ovariectomy, and extraction via a sac have been proposed as solutions to this problem.