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Laparoendoscopic Single-Site Surgery for Extremely Large Ovarian Cysts: A Feasibility, Safety, and Patient Satisfaction Study

Background/Aims: To assess the feasibility, safety and patient satisfaction of laparoendoscopic single-site (LESS) surgery for extremely large ovarian cysts. Methods: We conducted a prospective study of LESS surgery among women with ovarian cysts with a minimum diameter ≥15 cm and with radiological and laboratory features suggestive of benign disease. The primary outcomes were perioperative complication rate, conversion rate and patient satisfaction. Results: A total of 21 consecutive patients underwent the following LESS surgery over a period of 17 months: ovarian cystectomy (76%), adnexectomy (10%) and staging procedure (14%). Histological findings included benign (85%), borderline (10%) and malignant tumors (5%). Spillage occurred for 2 patients (10%). LESS surgery was successful without conversion in 20 patients (95%). There was 1 perioperative complication with subcutaneous hematoma (5%). The median operative time and estimated blood loss were 79.8 min (39-155) and 60 ml (10-180), respectively. Patients were highly satisfied with the results of LESS surgery, with a mean surgery satisfaction score of 9.4 ± 0.8 on a scale of 1-10. More than 71% of patients reported that the scar was invisible, and 95% said that they would recommend LESS surgery to others. Conclusion: Based on our results, with proper patient selection, the size of an ovarian cyst does not necessarily constitute a contraindication for LESS surgery.