What You Need to Know About Ovarian Cyst Surgery

While most ovarian cysts go away on their own, some of these fluid-filled sacs might need to be surgically removed. Patients with large ovarian cysts, painful symptoms, or suspicious imaging may be recommended for ovarian cyst surgery.

Ovarian cyst surgery is the removal of cysts from the ovaries either through small incisions (laparoscopically) or through one larger incision (laparotomy) in the abdomen. The recovery time depends on which surgery you have, and can range from a week to months.

This article discusses more about how to prepare for these procedures, what they entail, and any risks and complications.

What Is an Ovarian Cyst?

Ovarian cysts are fluid-filled sacs that can develop on or inside an ovary. Most of the time they develop during a person's reproductive years but in rare instances can occur after menopause. There are several types, the most common of which are functional cysts formed during ovulation.

Most of the time ovarian cysts come with no symptoms, but they can sometimes cause a dull ache, pressure, or a sense of bloating in the abdomen.

While most ovarian cysts resolve on their own, surgery is sometimes necessary to treat ovarian cysts. A healthcare provider may advise surgery when:

• Your cyst doesn't disappear after a few menstrual cycles.
• Your cyst is extremely large or increasing in size.
• Your cyst might be cancerous.
• You are near menopause or past menopause.
• Your cyst ruptures.

Preparing for Surgery

Surgery may be considered an elective procedure and will be scheduled through your medical provider's office in advance. For ruptured ovarian cysts, there may be blood and fluid loss, necessitating an emergency surgery for cyst removal. 

You should expect to take a few days off from work for the procedure and for the recovery period after the surgery.

Before the surgery, you may be told to do the following:

• Provide a thorough list of current medications you're using.
• Schedule a ride home from the hospital with a support person.
• Check in at the predetermined arrival time to give the presurgical teams ample time to prepare you for surgery.

You may also be instructed to avoid:

• Eating or drinking anything after midnight the night before the surgery
• Drinking alcohol and smoking at least one day before surgery

Procedures

Healthcare providers generally recommend laparotomy or laparoscopic surgery to remove cysts.

Laparoscopy

Most cysts are removed using laparoscopy. This is a minimally invasive surgery that's recommended unless the cyst is unusually large or is suspected of being cancerous.

During laparoscopic surgery:

1. A small incision is made in the abdomen to place a tiny camera and a separate small incision is made for the surgeon to insert an instrument with which to perform the procedure.
2. The cyst is dissected off of the ovary, if possible (or the entire ovary may need to be removed).
3. The cyst tissue is removed from the body.
4. The surgeon removes the camera and instruments and then closes the tiny incisions with small sutures.
5. Dressings will be applied to keep the incisions clean, dry, and intact. 

Most patients will be discharged following laparoscopic surgery and can return to normal activities within a week.

Laparotomy

Laparotomy surgery may be performed for large cysts that cannot be easily removed from tiny incisions or for cysts that are suspected to be cancerous.

A single larger incision is made in the abdomen to access the cyst. The layers of muscle and skin are sewn back together and dressings are placed after the procedure is done.

Patients who had a laparotomy procedure will stay in the hospital for two to four days, and most people return to normal activities at 12 weeks.

Recovery

People can typically leave the hospital not long after laparoscopy surgery and can resume normal activities within a week. It's best to rest and relax within 24 hours of your surgery. After that, there are no restrictions on the activities you can do as long as you're not taking narcotics, which can make you drowsy. If you're taking narcotics, refrain from driving, playing sports, or using heavy equipment.

Postoperative symptoms for laparoscopy recovery can include:

• Dizziness
• Nausea
• Shoulder pain
• Abdominal cramps
• Gassy or bloated feeling
• Sore throat if a breathing tube was placed for the procedure

For a laparotomy, it can take about three months to fully recover. It's important to follow your surgeon's post-operative instructions, which may include:

• Sticking to your treatment plan, which could entail an opioid medication followed by Tylenol acetaminophen
  
• Avoiding lifting anything greater than 5 pounds for six weeks
• Avoiding driving until it's no longer painful to press on the pedals and you're no longer taking opioid medications
• Arranging for a family member or friend to help you with chores at home

You will have a couple follow-up appointments with your surgeon so that they can check your incision, remove any stitches or tape, and answer your questions. If the incisions begin to bleed or leak pus, it’s important to get in touch with your surgeon right away because it may be infected. 

Risks and Complications

As with any surgery, there are risks with ovarian cyst removal surgery, including:

• Pain may not be controlled
• Scar tissue (adhesions) may form at the surgical site, on the ovaries or fallopian tubes, or in the pelvis
• Infection
• Damage to the bowel or bladder
• Damage the affected ovary, which could affect fertility

Benefits

The purpose of ovarian cyst surgery is to remove the cysts that are either causing symptoms or are cancerous. Some benefits of removal include:

• Relief from symptoms, such as pain, bloating, and bleeding
• Helping to prevent or treat cancer
• Peace of mind

Questions to Ask Your Healthcare Provider

If a healthcare provider recommends ovarian cyst surgery, some questions to ask include:

• Will I be at risk of getting another ovarian cyst in the future?
• Can having surgery make it harder to get pregnant?
• What does the procedure entail?
• How long do I stay in the hospital?
• How long is the recovery?
• What are the complications of surgery?
• What will happen if I don't get surgery?
• What are the costs?

Summary

Ovarian cyst surgery is a procedure through which ovarian cysts, fluid-filled sacs that develop on the ovaries, are removed. Your healthcare provider may recommend surgery if your cysts are particularly large, are causing problems, or are cancerous.

The surgery can be done by laparoscopy, which is performed with small incisions and a camera. Or it can be done by laparotomy, in which an incision is made in the abdomen to access the cysts. It can take about a week to recover from a laparoscopy, while it can take up to three months to return to normal daily activities after a laparotomy.