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What my patients have said ...

Dear Mr Tailor… I would like to thank you, your pleasant and very efficient secretary and everyone I met for assessment at day surgery. Although you all are caring for many people, there was time for each patient – explaining and comforting – no rush. Thank you all for making this a positive experience.

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Ovarian Cysts

ovarian cyst
Benign ovarian cyst

Ovarian cysts are common. Most women in their reproductive age will have at some point developed a cyst on their ovary and never realised! These are called physiological cysts which are natural and disappear spontaneously within 6 weeks. It is those that persist beyond a few weeks which are called “pathological”. However, even amongst these, the vast majority (>80%) are benign (non-cancerous). Some are found incidentally when the woman happens to have a pelvic scan for an unrelated reason. Others are found because the woman complains of pain or bloating and has an ultrasound scan which detects it.

If you are found to have a cyst, it is vital that you are adequately investigated prior to resorting to any surgery. This is because it is crucial to ensure that the cyst is not likely to be sinister. This can often be determined from the ultrasound scan and the CA125 blood test (ovarian cancer tumour marker). Occasionally you require an MRI or CT scan to characterise it further. I see a lot of women who are referred with an ovarian cyst because I carry out a detailed ultrasound scan to predict the possibility of anything sinister. I have been carrying out these scans since 1994 when I started a research project to find ways of predicting malignancy in cysts. I have published articles on this subject and regularly given lectures on this topic.

ovarian cyst
Benign ovarian cyst

If a cyst is thought to be sinister then they have to be managed by a specialist in gynaecological cancers (like myself) because it can require extensive surgery to remove all remnants of the cancer and “stage” it, ie, determine how far it has spread. This involves surgery to remove lymph glands which are in close proxity of major blood vessels and hence requires delicate surgery to prevent damage to these vessels and catastrophic blood loss!

If a cyst is thought to be benign and needs surgery then it is perfectly reasonable to carry it out by keyhole technique. Whilst this is often possible to achieve via simple conventional laparoscopic techniques, occasionally, it can be advantageous to be able to do it by robotic technique. This is especially so if the cyst needs to be “shelled out” so that the patient is still left with both ovaries.

ovarian cystectomy
Benign ovarian cyst being "shelled out"



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