Abstract
INTRODUCTION: Abdominal cystic lesions are a diverse spectrum of pathologies, predominantly ovarian in origin, including benign functional cysts to malignant neoplasms. This report presents a novel laparoscopic technique for resection of large abdominal cysts with oncological safety. CASE PRESENTATION: A 23-year-old female had a 2-year history of progressive abdominal distension. A 30 × 25.6 × 16.8 cm midline intraperitoneal cystic lesion was seen on imaging. A laparoscopic approach was adopted with protected cyst aspiration, exploration, and cystectomy of a right ovarian cyst, preserving the ovary and fallopian tube. Histopathology confirmed ovarian cystadenofibroma. The excised cyst measured 19 × 21 × 8 cm and weighed 11.5 kg. CLINICAL DISCUSSION: The minimally invasive approach minimized morbidity and improved cosmetic outcomes despite conversion to a small Pfannenstiel incision due to the cyst's size and limited gynecological laparoscopic expertise. CONCLUSION: Laparoscopic surgery for massive adnexal pathologies warrants further research into predictive factors for successful outcomes.