Description

This video demonstrates a Skin-to-Skin Laparoscopic Paraovarian Cystectomy for the removal of a large paraovarian cyst, performed at World Laparoscopy Hospital (WLH). The procedure showcases a meticulous minimally invasive surgical technique focused on complete cyst excision while preserving the ovary and fallopian tube whenever feasible. The video provides an educational step-by-step overview of the operation, making it valuable for gynecologists, laparoscopic surgeons, residents, and fellows interested in advanced gynecologic endoscopic surgery. Paraovarian cysts arise from the mesosalpinx adjacent to the ovary and account for a significant proportion of adnexal masses. While many remain asymptomatic, larger cysts can present with pelvic pain, abdominal distension, urinary symptoms, infertility, or acute complications such as torsion or rupture. Laparoscopic management has become the preferred approach because it allows excellent visualization of pelvic anatomy, precise dissection, reduced postoperative pain, minimal blood loss, faster recovery, shorter hospital stay, and superior cosmetic outcomes. In this unedited skin-to-skin surgical video, viewers can observe every stage of the operation—from laparoscopic access and diagnostic pelvic assessment to careful identification of the paraovarian cyst, atraumatic dissection from surrounding tissues, preservation of normal adnexal structures, complete cyst removal, meticulous hemostasis, specimen retrieval, and final inspection of the pelvis. The procedure emphasizes gentle tissue handling, maintenance of anatomical planes, and adherence to principles of safe minimally invasive surgery. The operation highlights the importance of preserving ovarian reserve, particularly in women of reproductive age. By carefully separating the cyst from the ovary and fallopian tube, the surgeon minimizes unnecessary tissue damage while achieving complete excision. Throughout the procedure, attention is given to avoiding cyst rupture whenever possible, protecting adjacent pelvic organs, and ensuring effective hemostasis before completion of the surgery. This educational video is intended for surgeons seeking to refine their laparoscopic skills in the management of adnexal masses. It demonstrates operative planning, port placement strategy, ergonomic instrument handling, precise dissection techniques, and evidence-based surgical decision-making. The case also illustrates how minimally invasive surgery can safely manage large paraovarian cysts while maximizing patient safety and preserving future reproductive potential.