Evidence - Oophorectomy, laparoscopic, robot-assisted laparoscopy (DaVinci)

• Symptomatic cysts: Large or painful cysts that cause discomfort, such as pelvic pain or a feeling of pressure in the abdomen
• Persistent cysts: Cysts that do not regress on their own and remain for an extended period
• Risk of torsion: Cysts that pose the risk of ovarian torsion (twisting of the ovary), which can lead to acute pain and emergencies 

According to a study, the most common benign ovarian cysts were endometriosis cysts and dermoid cysts.

Reference: 

1. Lok IH, Sahota DS, Rogers MS, Yuen PM. Complications of laparoscopic surgery for benign ovarian cysts. J Am Assoc Gynecol Laparosc. 2000 Nov;7(4):529-34. doi: 10.1016/s1074-3804(05)60369-6. PMID: 11044507.
2. Northridge JL. Adnexal Masses in Adolescents. Pediatr Ann. 2020 Apr 1;49(4):e183-e187. doi: 10.3928/19382359-20200227-01. PMID: 32275763.

Overall complication rate: The overall rate of complications in laparoscopic procedures for the removal of benign ovarian cysts is approximately 13.3%

Severe complications: Severe complications occur in about 0.6% of cases. These include injuries to the small intestine and ureters

Conversion to laparotomy: The necessity to switch from a laparoscopic to an open surgery (laparotomy) is less than 1%

Postoperative complications: The postoperative complication rate is about 0.79% to 0.89%. The most common postoperative complications include infections and bleeding

Recurrence rate: The likelihood of recurrence of ovarian cysts after a laparoscopic ovarian cystectomy is approximately 22.6% for endometriosis cysts

Long-term complications: Long-term complications such as adhesions (scar tissue) and chronic pain occur less frequently but are still relevant. Additionally, the ovarian reserve may be impaired after an ovarian cystectomy, particularly with endometriosis cysts. Therefore, preserving ovarian tissue is crucial for patients who wish to maintain their fertility for the future.

Reference: 

1. Lok IH, Sahota DS, Rogers MS, Yuen PM. Complications of laparoscopic surgery for benign ovarian cysts. J Am Assoc Gynecol Laparosc. 2000 Nov;7(4):529-34. doi: 10.1016/s1074-3804(05)60369-6. PMID: 11044507.
2. Wacharachawana S, Phaliwong P, Prommas S, Smanchat B, Bhamarapravatana K, Suwannarurk K. Recurrence Rate and Risk Factors for the Recurrence of Ovarian Endometriosis after Laparoscopic Ovarian Cystectomy. Biomed Res Int. 2021 Jan 25;2021:6679641. doi: 10.1155/2021/6679641. PMID: 33575338; PMCID: PMC7857866.
3. Li RY, Nikam Y, Kapurubandara S. Spontaneously Ruptured Dermoid Cysts and Their Potential Complications: A Review of the Literature with a Case Report. Case Rep Obstet Gynecol. 2020 Mar 31;2020:6591280. doi: 10.1155/2020/6591280. PMID: 32292616; PMCID: PMC7150697.
4. Perlman S, Kjer JJ. Ovarian damage due to cyst removal: a comparison of endometriomas and dermoid cysts. Acta Obstet Gynecol Scand. 2016 Mar;95(3):285-90. doi: 10.1111/aogs.12841. Epub 2016 Jan 24. PMID: 26669273.