Giant Left Ovarian Endometrioma in a Reproductive-Aged Woman: A Laparoscopic Solution to a Diagnostic and Surgical Dilemma

Gök M., Tuncer H. A.

ESGE 34th Annual Congress, İstanbul, Türkiye, 19 - 22 Ekim 2025, cilt.17, sa.1, ss.523, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 17
  • Basıldığı Şehir: İstanbul
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.523
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background

The surgical management of ovarian endometriomas is often part of a comprehensive approach to endometriosis. Isolated endometriomas are rare. Laparoscopic cystectomy remains the gold standard for surgical treatment. However, this technique may impair ovarian function. Hemostasis of the cyst bed should be performed with care to preserve the ovarian stroma.

Methods

We performed the procedure using an excisional technique. The endometrioma was first opened, and its contents aspirated. The cavity was irrigated thoroughly. Using two grasping forceps, bimanual and counter-traction were applied to identify the dissection plane between the cyst wall and the ovarian cortex. The cyst capsule was then meticulously stripped from the normal ovarian tissue, sutured, and removed in an endobag.

Results

A laparoscopic ovarian cystectomy was successfully performed. The patient was discharged on postoperative day two. At follow-up, she demonstrated significant improvement in her symptoms. Pregnancy could not be assessed as the patient does not currently desire fertility.

Conclusions

Although the optimal treatment strategy for ovarian endometriomas remains controversial, laparoscopy continues to be the gold standard in surgical management. Endometrioma surgery is a technically demanding and evolving procedure that benefits from advanced laparoscopic techniques. The surgical goal should always be to minimize damage to the ovarian cortex. Excisional approaches significantly reduce recurrence risk compared to ablative techniques. Hormonal supp