Two chocolate cyst

  1. Is there a surgeon who can remove the chocolate cyst and save both ovaries? Would robotic surgery or open cut be more beneficial in the aid of saving both. One cyst is 5cm the other 8cm.
  • Kelly Ellice Houck asked 2 years ago
  • last edited 2 years ago
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Dr. Steve Vasilev, MD, Gynecologist, Endometriosis Surgeon*:


There is no reason to start with an open incision in the vast majority of situations. First, a minimally invasive approach should be at least attempted. The more expert the surgeon, the more likely the surgery would be completed without a big laparotomy incision. In terms of equipment, while experts continue to argue, there is zero question that technology helps at some point. Robotics offers a 3-D magnified camera, which means there is depth perception as compared to laparoscopy. There are laparoscopic simulated 3-D options available (3-D glasses as opposed to real binocular lenses as found in robotics), but most surgeons use the 2–D camera. Without depth perception, the surgeon can’t precisely tell the separation between tissues in a highly distorted anatomical situation. For example, there may be a section of bowel stuck to the endometrioma, or the blood vessels to the ovary may be obscured in inflammation. Dissecting this all safely is facilitated by a 3-D view. You can prove to yourself why 3-D is better. Put an eye patch on and try to (very carefully) try to do things around the house with only one eye to help you navigate. You will find that you underestimate or overestimate the distance between objects when you try to pick them up and might even bump into things too often. Hence you should not try this experiment without someone to help keep you steady. Humans are created with and are best equipped to function with 3-D vision. We can accommodate to 2-D but it is not natural or optimal.

The wristed instruments in robotics highly facilitate intricate surgery, especially in complex anatomy spaces. So, this technology is also critical to successful surgery completion. It’s like having a tiny set of hands inside, which can be even more precise than an incision and real human hands, which can actually get in the way.

In the end, the skill of the surgeon trumps all else. However, robotics can provide the edge to get the job done safely and with limited chances of converting to a laparotomy incision.


*This is not medical advice and is aimed for informational use only. Don’t hesitate to get in touch with the doctor’s office or consult your doctor for any medical questions.

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