Optimal Timing and Feasibility of Single-Port Laparoscopic Ovarian Cystectomy on Postpartum Day Two After Vaginal DeliveryA 25-year-old woman presented at 39 weeks and 5 days of gestation, delivering vaginally at 40 weeks and 3 days. Initially, a 5 cm ovarian cyst was detected via early pregnancy ultrasound, remaining asymptomatic. Subsequent monitoring revealed an increase in cyst size to approximately 15 cm. Two days post-delivery, she underwent transumbilical single-port laparoscopic surgery, with a 2.5 cm incision at the umbilicus allowing access for cyst removal. The surgery revealed a 15 cm cyst on the left ovary and an enlarged uterus. Approximately 1500 mL of clear fluid was aspirated via a lotus suture, with the cyst wall excised and the ovary sutured under direct visualization. Immediate pathology confirmed a serous cyst. The patient recovered well and was discharged 48 hours later. Representative surgical images are provided in Fig.1.During the puerperal period, the uterus enlarges and the adnexa ascend, facilitating their extraction through the single incision. The abdominal wall laxity eases single-port enlargement, aiding in suture placement and improving cosmetic outcomes [1].Managing ovarian cysts during pregnancy involves risks of adverse outcomes, such as miscarriage or preterm labor [2]. Enlarged uterus poses challenges, increasing risks of complications like ovarian torsion and rupture, necessitating emergency interventions if managed post-delivery [3]. For asymptomatic giant ovarian cysts carried to full term, timely postpartum single-port laparoscopic surgery may be beneficial, leveraging physiological changes to reduce risks and improve surgical outcomes. These findings highlight the importance of optimal timing for surgical intervention in cases of ovarian cysts during pregnancy.
