Optimal Timing and Feasibility of Single-Port Laparoscopic
Ovarian Cystectomy on Postpartum Day Two After Vaginal Delivery
A 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.