•Pain in the lower abdomen •Discomfort in the lower abdomen •Discomfort with intercourse •Difficult bowel movements •Frequent micturition

•Irregularity of the menstrual cycle •Abnormal vaginal bleeding •Precocious puberty •Early onset of menarche •Abdominal fullness •Bloating •Indigestion •Heartburn •Early satiety •Hirsutism •Infertility •Oligomenorrhea •Obesity •Acne •Cachexia •Weight loss •Ascites RISK ASSESSMENT •Stress •Obesity •Heart diseases •Bleeding disorders •Hypertension •Chronic or recent illness •Excessive use of alcohol

•Smoking •Pregnancy •Previous abdominal surgery •Endometriosis PREPARATION OF THE PATIENT •Blood tests •Urinalysis •X-ray of chest •X-ray lower intestinal tract •X-ray lower abdomen •ECG •Cancer antigen 125 (CA125) •USG •Endovaginal USG •Transabdominal USG •3-dimensional USG •Doppler flow studies •MRI •CT scan •Needle aspiration biopsy •Culdocentesis •Aspirin was stopped for one week before the procedure •Do not eat or drink for at least 8 hours before the procedure •She was prepped and draped in the usual sterile fashion ANESTHESIA
•General anesthesia •Spinal anesthesia


LAPAROSCOPIC SURGERY •With patient positioned in supine position part was prepared and draped •Small incision was made in the lower abdomen just below the navel. •Through this incision, laparoscope was inserted •Carbon dioxide gas was pumped into the abdomen, to inflate the abdomen •The cyst was located at _______ •One /two small incisions were made, through which surgical instruments were inserted •Cyst was removed •Surgical instruments were removed •The incisions were closed with stitches or clamps. •Dressing was done OPEN SURGERY
•An incision was made in the abdomen •The abdominal muscles were separated, and the abdomen was

opened. •Blood vessels that supply the ovaries were located, clamped, and tied. •The cyst was located at _______ •The cyst was surgically removed. •The abdominal muscles were sewn together with absorbable heavy stitches •The incision was closed with stitches or clamps. •Dressing was done AFTER PROCEDURE •The patient was shifted to intensive care unit •Blood pressure, heart rate, oxygenation was monitored •The removed tissue was sent to the pathology lab

FINDINGS Dermoid / endometrioma/ functional/ simple cyst was found DURATION ______min/hrs POSTOPERATIVE CARE •Take antibiotics as prescribed •Take pain medication as prescribed •Elevate your legs while resting in bed •Avoid strenuous exercise for 2-6 weeks •Do not resume sexual activity for 2 weeks •Do not use tampons for 2 weeks •Do not douche for 2 weeks •Keep the incisional area dry, and clean COMPLICATIONS •Infection •Bleeding •Recurrence of ovarian cysts •Recurrence of cancer •Need for removal of one or both ovaries •Infertility •Adhesion formation

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