Ovarian cyst elevation using a metreurynter for laparoscopic cystectomy of a benign ovarian cyst during pregnancy

BMC Pregnancy Childbirth. 2021 Apr 23;21(1):321. doi: 10.1186/s12884-021-03774-w.

Abstract

Background: A uterine manipulator cannot be used to elevate the ovary in benign ovarian surgery during pregnancy. This report describes our method of elevation of the ovary using a metreurynter with the success rate of the procedure and a comparison of surgical results and pregnancy outcomes between the successful and unsuccessful cases.

Methods: Between August 2003 and February 2020, 11 pregnant patients with a tumor found sunk in the Cul-de-sac underwent laparoscopic cystectomy for a benign ovarian cyst with a metreurynter. The surgical results, success and failure of the elevation by a metreurynter, pregnancy outcomes, and fetal status at delivery were evaluated.

Results: Elevation of ovarian tumors with a metreurynter was successful in nine cases. However, it was unsuccessful in the remaining two cases wherein the ovary was lifted with forceps while the uterus was in a compressed state. The operative time was also longer in these cases. The pregnancy prognosis, however, was good for both, successful and unsuccessful cases.

Conclusions: The metreurynter is an inexpensive and practical obstetric device, and its optimal use allows the performance of a procedure with minimal burden on a pregnant uterus. Therefore, we recommend the appropriate use of this method to enable effective laparoscopic cystectomy of ovarian tumors during pregnancy.

Keywords: Laparoscopic surgery; Metreurynter; Ovarian cyst elevation; Ovarian tumor; Pregnancy.

MeSH terms

  • Adult
  • Douglas' Pouch / surgery*
  • Female
  • Humans
  • Intraoperative Complications* / etiology
  • Intraoperative Complications* / prevention & control
  • Laparoscopy* / adverse effects
  • Laparoscopy* / instrumentation
  • Laparoscopy* / methods
  • Lifting / adverse effects
  • Operative Time
  • Ovarian Cysts* / pathology
  • Ovarian Cysts* / surgery
  • Ovariectomy* / adverse effects
  • Ovariectomy* / methods
  • Pneumoperitoneum, Artificial / methods
  • Pregnancy
  • Pregnancy Complications* / pathology
  • Pregnancy Complications* / surgery
  • Pregnancy Outcome
  • Surgical Instruments* / adverse effects
  • Surgical Instruments* / classification
  • Uterus / injuries