{"id":2623,"date":"2020-08-13T17:59:17","date_gmt":"2020-08-13T17:59:17","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=334"},"modified":"2020-08-13T17:59:17","modified_gmt":"2020-08-13T17:59:17","slug":"removal-of-a-dermoid-cyst","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/pa_obgyn\/surgery-2\/removal-of-a-dermoid-cyst\/","title":{"rendered":"Removal of a Dermoid Cyst"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/wB-r0Lfl9yA\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Duration 4:22<\/p>\n<input type='hidden' bg_collapse_expand='69e9b59b641ef5011092641' value='69e9b59b641ef5011092641'><input type='hidden' id='bg-show-more-text-69e9b59b641ef5011092641' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9b59b641ef5011092641' value='Hide Transcript'><button id='bg-showmore-action-69e9b59b641ef5011092641' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9b59b641ef5011092641' ><\/p>\n<p>00:00<br \/>\nhi this is dr. Vitali presenting a an<br \/>\n00:04<br \/>\nexample of a treatment of a simple<br \/>\n00:08<br \/>\novarian dermoid cyst as you are aware<br \/>\n00:12<br \/>\ndermoid cyst are quite common and they<br \/>\n00:17<br \/>\ncan be symptomatic or asymptomatic they<br \/>\n00:19<br \/>\nhave a tendency to be bilateral in this<br \/>\n00:22<br \/>\npatients case this was a real because<br \/>\n00:25<br \/>\nshe had a dermal on the opposite side<br \/>\n00:27<br \/>\nand and the surgeon had not noticed and<br \/>\n00:31<br \/>\nit was a while ago so he might have been<br \/>\n00:33<br \/>\nvery small that there was a cyst on the<br \/>\n00:36<br \/>\ncontralateral &#8211; on the opposite ovary<br \/>\n00:38<br \/>\nthe only case their modes are well known<br \/>\n00:40<br \/>\nthey&#8217;re also called mature cystic<br \/>\n00:43<br \/>\nteratomas because they they derive<br \/>\n00:46<br \/>\nembryologically from a skin element so<br \/>\n00:50<br \/>\nyou can find inside these cysts hair or<br \/>\n00:55<br \/>\nteeth and they&#8217;re quite scary for the<br \/>\n00:59<br \/>\ninexperienced person to look at for<br \/>\n01:02<br \/>\nregular people because they it&#8217;s kind of<br \/>\n01:04<br \/>\ndisturbing to think that you have a cyst<br \/>\n01:06<br \/>\nwith actual human hair inside your your<br \/>\n01:09<br \/>\novaries inside your body most of them<br \/>\n01:12<br \/>\nare behind a great majority of them and<br \/>\n01:14<br \/>\nthey should be removed if they are<br \/>\n01:16<br \/>\nleaking if they create problems<br \/>\n01:18<br \/>\nsometimes they can cock they can easily<br \/>\n01:19<br \/>\ncause a twisting of the ovary like in<br \/>\n01:21<br \/>\nthis case where the dermoid which is a<br \/>\n01:24<br \/>\nlittle bit heavy is on one extreme of<br \/>\n01:26<br \/>\nthe ovary in allowing it to twist and<br \/>\n01:28<br \/>\ncause pain and strangulate the ovary the<br \/>\n01:31<br \/>\ncysts can be removed very easily well<br \/>\n01:35<br \/>\nthis is a small one in most cases easily<br \/>\n01:37<br \/>\nthe key is not to allow for any leakage<br \/>\n01:40<br \/>\nbecause the tissue from the dermoid can<br \/>\n01:42<br \/>\nbe very irritating to the valley&#8217;s in<br \/>\n01:44<br \/>\ncause car tissue and so it should be<br \/>\n01:46<br \/>\npeeled off very gently without damaging<br \/>\n01:48<br \/>\nthe ovaries and i do this procedure<br \/>\n01:49<br \/>\nroutinely this is a small one but it<br \/>\n01:51<br \/>\ngives an idea of what we do and I like<br \/>\n01:53<br \/>\nto use two graspers here with a rope<br \/>\n01:55<br \/>\nwith a DaVinci robot and just like<br \/>\n01:57<br \/>\ngently nudge it off minimal bleeding or<br \/>\n02:00<br \/>\nalmost no bleeding at all and I do not<br \/>\n02:05<br \/>\nrepair suture the defect is being shown<br \/>\n02:07<br \/>\nthat stitches create more adhesions and<br \/>\n02:10<br \/>\nthe key is just to leave here there was<br \/>\n02:13<br \/>\na little bit<br \/>\n02:13<br \/>\nof a breach because the and you could<br \/>\n02:16<br \/>\nsee I slowed it down here some of that<br \/>\n02:18<br \/>\nfatty skin material coming out and you<br \/>\n02:22<br \/>\ncan see the human hair also popping out<br \/>\n02:27<br \/>\na little bit so we of course immediately<br \/>\n02:29<br \/>\nuse the suction and make sure that<br \/>\n02:30<br \/>\nthere&#8217;s no leakage at all very important<br \/>\n02:34<br \/>\nand yes you know the hair is a little<br \/>\n02:36<br \/>\nbit gross for people to look at and a<br \/>\n02:39<br \/>\nlittle bit disturbing if you&#8217;re the<br \/>\n02:40<br \/>\npatient having this because it makes you<br \/>\n02:42<br \/>\nthink what is this but it&#8217;s common and<br \/>\n02:45<br \/>\nit&#8217;s it&#8217;s not bad<br \/>\n02:47<br \/>\nyou can see the hair there so as I was<br \/>\n02:50<br \/>\nsaying you know the keys not to allow<br \/>\n02:52<br \/>\nanything to leak ideally one would want<br \/>\n02:55<br \/>\nnot to rupture the cyst at all but<br \/>\n02:58<br \/>\nsometimes it does happen that you have a<br \/>\n02:59<br \/>\nsmall breach because it&#8217;s it can get<br \/>\n03:02<br \/>\nsticky on the ovary so you&#8217;ll get a<br \/>\n03:04<br \/>\nlittle bit of a leak nothing unusual in<br \/>\n03:09<br \/>\nany case these cysts are like i said in<br \/>\n03:11<br \/>\nmost cases benign and very commonly<br \/>\n03:15<br \/>\nthey&#8217;re bilateral so it&#8217;s easy to miss<br \/>\n03:17<br \/>\nif the doctor is not aware of this who<br \/>\n03:20<br \/>\nmissed the ovary on the contralateral<br \/>\n03:22<br \/>\nthe cyst on the contralateral ovary and<br \/>\n03:26<br \/>\nand that can result in a second<br \/>\n03:30<br \/>\noperation which could have been avoided<br \/>\n03:33<br \/>\nin any case you can see that the cyst<br \/>\n03:36<br \/>\npeels off quite well at the base usually<br \/>\n03:39<br \/>\nit&#8217;s a little bit stickier a little bit<br \/>\n03:40<br \/>\nmore vascular I try to use almost no no<br \/>\n03:47<br \/>\ncoagulation on the ovary just a tiny bit<br \/>\n03:49<br \/>\nthere on the pedicle and that&#8217;s pretty<br \/>\n03:50<br \/>\nmuch it so that the ovary keeps its<br \/>\n03:53<br \/>\novarian reserve and he&#8217;s not damaged and<br \/>\n03:55<br \/>\nit doesn&#8217;t damage future fertility is<br \/>\n03:57<br \/>\nminimal minimal bleeding almost no<br \/>\n03:59<br \/>\nbleeding and just maybe one tiny leader<br \/>\n04:02<br \/>\nthat I have to touch and that&#8217;s pretty<br \/>\n04:03<br \/>\nmuch it that&#8217;s it so no excessive<br \/>\n04:06<br \/>\ncoagulation nothing major healthy ovary<br \/>\n04:09<br \/>\njust drop back into the pelvis and you<br \/>\n04:12<br \/>\nwill heal beautifully again if you have<br \/>\n04:15<br \/>\neither endometriosis or pelvic pain or<br \/>\n04:18<br \/>\nany other problems reach out to me<br \/>\n04:19<br \/>\ndr. Vitali endometriosis is real<\/p>\n<p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Duration 4:22<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":784,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2623","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2623","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/comments?post=2623"}],"version-history":[{"count":0,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/2623\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/784"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/media?parent=2623"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}