[Laparoscopic resection of ovarian cysts: precautions and improvements in the procedure and application of the mini-laparotomy].

We previously devised and reported a laparoscopic resection of benign ovarian cysts. In the present paper, we report precautions and improvements in the procedure and the application of the mini-laparotomy. 1. The subjects consisted of a total of 41 cases with preoperatively diagnosed cysts. These were 17 cases with simple cysts, 15 cases with dermoid cysts, and nine cases with chocolate cysts. The present surgical procedure was performed on 34 (83%) cases. 2. One case, preoperatively diagnosed as a chocolate cyst, was diagnosed as an endometrioid adenocarcinoma. 3. Laparotomy was required in 7 cases; in four as a result of hard adhesions, in one because it was impossible to withdraw fluid, in one due to a damaged urinary bladder and in one due to endometrioid adenocarcinoma. 4. It became essential to classify the ovarian cysts into three groups according to size. 5. Mini-laparotomy was performed for two giant ovarian cysts and five ovarian cysts in pregnant women. In this procedure the goal is minimal, simple, safe and reliable surgery with results equal to those of standard laparotomy.