The operation for ovarian resection is performed under general anesthesia: the drug is administered intravenously and the patient "falls asleep" on the operating table. Further, depending on the type of surgery performed, the surgeon does certain actions:
- Laparoscopic ovarian resection involves three punctures, one in the navel and the other two in the ovarian projection zone;
- Laparotomic resection of the ovary is carried out by one relatively large incision of the tissues to gain access to the organs.
Further, the medical instruments are inserted into the abdominal cavity, with which the surgeon conducts appropriate manipulations:
- relieves the operated organ for resection (separates from adhesions and located near other organs);
- puts a clamp on the ovarian ligament suspension;
- conducts the necessary variant of ovarian resection;
- cauterizes and sutures damaged vessels;
- sutures damaged tissue with catgut;
- conducts a diagnostic examination of the reproductive organs and assesses their condition;
- if necessary, performs the elimination of other pelvic problems;
- establishes drains for outflow of fluid from the operating wound;
- removes tools and sutures outer fabrics.
In some cases, a planned laparoscopic operation can be transformed into a laparotomic procedure: everything depends on what changes in the organs the surgeon sees when they are directly accessed.
Resection of both ovaries
If the removal of both ovaries is performed, then this operation is called oophorectomy. Usually it is carried out:
- with malignant organ damage (in this case, resection of the uterus and ovaries is possible, when the ovaries, tubes and partially the uterus are removed);
- with significant cystic formations (in women who do not plan to have more children - usually after 40-45 years);
- with glandular abscesses;
- with total endometriosis.
Resection of both ovaries can be carried out and unscheduled - for example, if before laparoscopy another, less severe diagnosis was put. Ovaries are often removed from patients after 40 years of age to prevent their malignant degeneration.
The most common resection of both ovaries with bilateral endometrioid or pseudomucinous cysts. With papillary cystoma, resection of the uterus and ovaries can be applied, since such a tumor has a high probability of malignancy.
Resection of the ovaries is divided into total (full) and subtotal (partial). Partial ovarian resection is less traumatic for the organ and allows you to maintain a normal ovarian reserve and ability to ovulate.
Partial resection is used in most cases with single cysts, inflammatory changes and thickening of the ovary tissues, with ruptures and torsions of the cysts.
This option of surgery allows the organs to recover quickly and resume their function.
One of the variants of partial resection is wedge resection of the ovary.
Re-resection of the ovaries
Repeated operation on the ovaries can be prescribed in case of polycystosis (not earlier than 6-12 months after the first resection), or if a cyst is relapsed.
Some patients have a tendency to form cysts - this predisposition can be hereditary. In such cases, cysts often occur repeatedly, and you again have to resort to surgery. It is especially important to re-resect if a dermoid cyst is found that is larger than 20 mm, or a woman can not become pregnant for a long time.
If the operation is carried out under polycystosis, then repeated resection gives the woman an additional chance to conceive a child - and this is recommended for six months after the surgery.