European Journal of Obstetrics & Gynecology and Reproductive Biology 81 (1998) 47–50 Surgical treatment of ovarian dermoid cysts * Giuseppe Morgante , Antonino Ditto, Antonio la Marca, Valeria Trotta, Vincenzo De Leo Siena University, Department of Gynecology and Obstetrics, 53100 Siena, Italy Received 25 May 1998; received in revised form 15 June 1998; accepted 18 June 1998 Abstract Objective: To evaluate the efficacy of laparoscopic ovarian cystectomy and to compare the surgical course, post-surgical course and particularly post-surgical pain of the laparoscopic and laparotomic methods. Study design: We conducted a surgical study on dermoid cysts at the Gynecology Department of Siena University between 1 January 1992 and 31 December 1996. The selected cases were randomized into two groups based on surgical approach: via laparotomy (n522) or laparoscopy (n522). Surgical times, estimated blood loss, post-surgical pain, time in hospital, speed of recovery and complications were compared. Results: Mean blood loss was significantly less for laparoscopy (58.64630.17 ml versus 103.84638.45 ml, P,0.05). Mean hospitalization was 6.3261.09 days for laparotomy and 3.1860.39 days for laparoscopy (P,0.05). Post-surgical pain was significantly less in laparoscopy patients (P,0.05). The laparoscopic technique had fewer post-surgical complications. Conclusions: The laparoscopic approach had many advantages. Laparoscopy should be the elective treatment for women with dermoid cysts, because it has many advantages for the patient and lower costs for the national health system.  1998 Elsevier Science Ireland Ltd. All rights reserved. Keywords: Laparotomy; Laparoscopy; Dermoid cysts; Ovary 1. Introduction on clinical examination and ultrasonographic indications, confirmed by radiological evidence of solid cystic residues Dermoid cysts of the ovary are often diagnosed in in the ovaries [5]. The standard treatment for benign cystic women of reproductive age and account for 5–25% of all teratoma is laparotomy with surgical removal of the ovarian tumours [1]. Ninety-nine percent of teratomas are ovarian cysts or oophorectomy and salpingectomy in benign. The period of maximum incidence of these tumors postmenopausal women. is between 30 and 40 years of age [2]. Neoplastic The advent of new, much less invasive techniques, such transformation is rare and generally begins from epithelial as laparoscopy, has revolutionized this sector of elements; the most common form of transformation is gynecological surgery. Many studies have shown that squamous cell carcinoma; adenocarcinoma and the car- laparoscopic treatment of ovarian masses is satisfactory [6] cinoid form are much less frequent [3]. and that laparoscopic diagnosis of malignant tumours of The clinical course of dermoid cysts of the ovary is the ovaries has good sensitivity in expert hands [7]. The asymptomatic and torsion or spontaneous rupture (fol- risk of spillage or inadvertent puncturing of a malignant lowed by acute chemical peritonitis) only occur in 16% neoplasm is very low. Laparoscopic treatment of benign and 3–7% of patients, respectively [4]. Diagnosis is based ovarian cysts does not prejudice fertility. In this paper we report our experience in the treatment * of ovarian cystic teratomas by laparotomy and laparos- Corresponding author. Tel.: 139 577 331160; Fax: 139 577 263464; e-mail:morgante@unisi.it copy. Our purpose is to evaluate the two techniques in 0301-2115 / 98 / $19.00  1998 Elsevier Science Ireland Ltd. All rights reserved. PII: S0301-2115(98)00139-0