A prospective, randomized comparison of port wound and culdotomy for extracting mature teratomas laparoscopically

Study Objective. To compare removing teratomas through a culdotomy opening or through an enlarged port wound. Design. Prospective, randomized trial (Canadian Task Force classification I). Setting. Veterans Hospital. Patients. Thirty-one women with mature teratomas identified by ultrasound examination and biochemical markers. Intervention. Laparoscopic cystectomy. Measurements and Main Results. Patients were randomly assigned to have the cysts removed intact in a cellulose bag through an enlarged port site (15, group A) or through a culdotomy opening (16, group B). Inclusion criteria were history of vaginal delivery, no previous abdominal surgery, no history of pelvic inflammatory disease, no medical illness, and no symptoms. Operating time in group B (90 +/- 18 min) was significantly longer than that in group A (70 +/- 22 min, p = 0.0113). Blood loss was 79 and 49 ml, respectively (p = 0.0010). There was no significant differences in tumor size, patient age, and postoperative recovery between groups. Conclusion. It is possible to remove intact ovarian dermoid cysts and prevent rupture and spillage of cyst contents during laparoscopic surgery by both approaches. We prefer the enlarged port because operating time is shorter and blood loss is less.