Removal of a Dermoid Cyst

Duration 4:22

00:00
hi this is dr. Vitali presenting a an
00:04
example of a treatment of a simple
00:08
ovarian dermoid cyst as you are aware
00:12
dermoid cyst are quite common and they
00:17
can be symptomatic or asymptomatic they
00:19
have a tendency to be bilateral in this
00:22
patients case this was a real because
00:25
she had a dermal on the opposite side
00:27
and and the surgeon had not noticed and
00:31
it was a while ago so he might have been
00:33
very small that there was a cyst on the
00:36
contralateral – on the opposite ovary
00:38
the only case their modes are well known
00:40
they’re also called mature cystic
00:43
teratomas because they they derive
00:46
embryologically from a skin element so
00:50
you can find inside these cysts hair or
00:55
teeth and they’re quite scary for the
00:59
inexperienced person to look at for
01:02
regular people because they it’s kind of
01:04
disturbing to think that you have a cyst
01:06
with actual human hair inside your your
01:09
ovaries inside your body most of them
01:12
are behind a great majority of them and
01:14
they should be removed if they are
01:16
leaking if they create problems
01:18
sometimes they can cock they can easily
01:19
cause a twisting of the ovary like in
01:21
this case where the dermoid which is a
01:24
little bit heavy is on one extreme of
01:26
the ovary in allowing it to twist and
01:28
cause pain and strangulate the ovary the
01:31
cysts can be removed very easily well
01:35
this is a small one in most cases easily
01:37
the key is not to allow for any leakage
01:40
because the tissue from the dermoid can
01:42
be very irritating to the valley’s in
01:44
cause car tissue and so it should be
01:46
peeled off very gently without damaging
01:48
the ovaries and i do this procedure
01:49
routinely this is a small one but it
01:51
gives an idea of what we do and I like
01:53
to use two graspers here with a rope
01:55
with a DaVinci robot and just like
01:57
gently nudge it off minimal bleeding or
02:00
almost no bleeding at all and I do not
02:05
repair suture the defect is being shown
02:07
that stitches create more adhesions and
02:10
the key is just to leave here there was
02:13
a little bit
02:13
of a breach because the and you could
02:16
see I slowed it down here some of that
02:18
fatty skin material coming out and you
02:22
can see the human hair also popping out
02:27
a little bit so we of course immediately
02:29
use the suction and make sure that
02:30
there’s no leakage at all very important
02:34
and yes you know the hair is a little
02:36
bit gross for people to look at and a
02:39
little bit disturbing if you’re the
02:40
patient having this because it makes you
02:42
think what is this but it’s common and
02:45
it’s it’s not bad
02:47
you can see the hair there so as I was
02:50
saying you know the keys not to allow
02:52
anything to leak ideally one would want
02:55
not to rupture the cyst at all but
02:58
sometimes it does happen that you have a
02:59
small breach because it’s it can get
03:02
sticky on the ovary so you’ll get a
03:04
little bit of a leak nothing unusual in
03:09
any case these cysts are like i said in
03:11
most cases benign and very commonly
03:15
they’re bilateral so it’s easy to miss
03:17
if the doctor is not aware of this who
03:20
missed the ovary on the contralateral
03:22
the cyst on the contralateral ovary and
03:26
and that can result in a second
03:30
operation which could have been avoided
03:33
in any case you can see that the cyst
03:36
peels off quite well at the base usually
03:39
it’s a little bit stickier a little bit
03:40
more vascular I try to use almost no no
03:47
coagulation on the ovary just a tiny bit
03:49
there on the pedicle and that’s pretty
03:50
much it so that the ovary keeps its
03:53
ovarian reserve and he’s not damaged and
03:55
it doesn’t damage future fertility is
03:57
minimal minimal bleeding almost no
03:59
bleeding and just maybe one tiny leader
04:02
that I have to touch and that’s pretty
04:03
much it that’s it so no excessive
04:06
coagulation nothing major healthy ovary
04:09
just drop back into the pelvis and you
04:12
will heal beautifully again if you have
04:15
either endometriosis or pelvic pain or
04:18
any other problems reach out to me
04:19
dr. Vitali endometriosis is real

Introductory Women's HealthCare