LAPAROSCOPIC MANAGEMENT OF LARGE OVARIAN ENDOMETRIAL CYST - USE OF FIBRIN SEALANT

In order to prevent postoperative adhesions often present after CO2 laser vaporization of large endometriomas, 62 patients with endometriomas > 3 cm diameter were treated with a new procedure. Partial cystectomy was performed using the CO2 laser. Residual endometrial cyst was then vaporized. After laparoscopic vaporization of the interior cyst wall, a fibrin glue (Tissucol) was injected onto the vaporized area to close laparoscopically the ovarian cyst cavity. When performed, second-look laparoscopy demonstrated healing of the ovary without any periovarian adhesions. The incidence of periovarian adhesions was significantly lower (p < 0.01) than in the group of women treated by laparoscopy and in whom the glue was not used to close the ovarian cyst cavity.