Laparoscopically directed ovarian cystectomy in premenopausal women. Impact of surgical experience on surgical time.

The purpose of this study was to correlate surgical experience with operating efficiency. A retrospective review of 303 operative laparoscopic procedures was performed during a 48-month interval and during the acquisition of surgical skills by one faculty member. Population demographics and surgery time were evaluated in 41 cases (13.5%) of ovarian cystectomy. Patients were categorized into fertility-related or gynecologic indications for surgery. Surgical time for successful laparoscopically directed resection of benign ovarian cysts was significantly reduced over the study interval (P = .008). Endometrioma was the most common pathologic finding in women with impaired fertility, and benign epithelial tumors were the lesion encountered most commonly in gynecologic patients. Benign teratoma occurred infrequently in both groups. No malignancy was observed in this group of premenopausal women, who had unilocular cysts less than 8 cm in diameter. Reduction in surgical time for laparoscopically directed ovarian cystectomy occurs after experience is gained by repeated application of the technique.