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What my patients have said ...

I would like to take this opportunity to thank you for your kindness during my recent hysterectomy... as you know I have had several gynaecological operations and I can honestly say that, although this operation was by far the most serious one, it was the least upsetting, both physically and psychologically. This was mainly due to your expertise in the operating theatre. It took a great deal of time and trouble to ensure that there would be minimal scarring and bruising so that my postoperative recovery would be shortened. However I was also impressed by the time you spent to listen to patients and explain the procedures. All too often patients feel a passive partner in their surgery which is unhelpful psychologically but you ensured that I was kept informed at all times. Thank you.... I would also like to take this opportunity to pass on my thanks to your surgical team and your secretary. Everyone with whom I came into contact was extremely helpful and considerate which was very much appreciated.... I hope you will pass on my best wishes to all your staff. You undoubtedly have built a good team and I wish them and yourself all the best for the future. I will have no hesitation in recommending your skills to any friend who might need a gynaecologist.

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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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