Article Text
Abstract
Introduction/Background*Till recently primary surgery for ovarian cancer and borderline ovarian tumours was done by laparotomy irrespective of the stage of the disease. Slowly the role of minimally invasive surgery in selected cases of borderline ovarian tumours and early stage ovarian cancers is becoming well known.1
Methodology A 42 year old P2L2, previous 1 LSCS with history of Heavy Menstrual Bleeding and Abdominal pain not responding to medical management was evaluated outside. A pelvic ultrasound showed multiple intramural uterine fibroids, largest measuring 3cm and a 6 x 4 x 4cm mass in left adnexa away from the left ovary, with both ovaries appearing normal and visualised separately. Her Ca 125 was 121 IU/L. Magnetic Resonance Imaging of the pelvis was reported as multiple intramural fibroids and propable broad ligament mass. She was referred to our hospital for management. Patient underwent Robot assisted laparoscopic Staging with hysterectomy, B/L Salpingo-oopherectomy, Frozen section of the left adnexal mass, Bilateral Pelvic lymph node dissection, Omental biopsy, pelvic peritoneal biopsy.
Result(s)*Time taken for performing the surgery was 102 minutes. Frozen section of the left adnexal mass was reported as serous Borderline Ovarian tumour. Cytology of the peritoneal washing collected was reported to be negative for malignant cells. Pathological examination of the specimen showed Atypical proliferative serous tumour/serous borderline ovarian tumour of left ovary with surface involvement- FIGO stage I C2. Uterus had multiple leiomyoma. The pelvic nodes, omental tissue and the peritoneal tisssues were negative for implants or malignancy. The post- operative period was uneventful, and the patient was discharged on postoperative day 2.
Conclusion*Robot Assisted Laparoscopic staging surgery can be performed safely in selected cases by well-trained surgeons without compromising the oncological outcomes.