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One of the coolest things I’ve seen on the wards happened yesterday in the operating room. On my first day of benign surgical gynecology, I saw three laparoscopic procedures – a hysterectomy, a bilateral tubal ligation, and a bilateral ovarian dermoid cystectomy. While all of them were new experiences, it’s the cystectomy which totally blew me away.

We had set up the trocars and as soon as we inserted the camera, the bilateral cysts were in view and, to say the least, enormous (to the point where they were touching each other). The residents worked together to peel away the left ovarian capsule to delineate normal ovarian tissue from cystic tissue, but in the process, we encountered hair.

Hair in the ovary? Yes, this cyst was a kind of teratoma – a dermoid cyst. After draining significant amounts of purulent material as well as hair, we joked that two hours of labor would unlikely need to be reproduced for the other ovarian cyst since dermoids are bilateral only 10-15% of the time.

We approached the other ovary more head on by attempting to burst the cyst to drain it first. However, with the initial insertion of suction, we were greeted with another bout of hair. And lots of it.

Imagine a 10 cm hairball attached to a scant amount of ovarian tissue. Multiply that by 2, operate for 3.5 hours, and then witness the magnificent specimens dissected out laparoscopically. That was my evening yesterday.

I recollected the amount of adnexal pain the patient was experiencing pre-operatively, so I was glad to see that a.) the problem was what we thought it was from ultrasound and b.) we were able to successfully drain everything. Now I will never ever forget what a dermoid cyst presents with and looks like grossly.

Legal

As a third year medical student at Baylor College of Medicine, my posts are intended to educate others and share my experiences from this incredible journey without violating patient privacy at all costs. These blurbs are not to serve as a replacement for recommendations provided by licensed physicians under any circumstance.