Single Incision Laparoscopic Surgery for a Large Endometriotic Cyst
A 27-year-old single nulliparous lady (body mass index = 17.5) presented with a 3-day history of left iliac fossa and suprapubic pain which progressively got worse despite analgesia. The pain score of 8/10 upon presentation. There was no vaginal bleeding or discharge. She reported dysmenorrheal during her periods, requiring analgesia.\nAbdominal examination revealed a normal-sized uterus with tenderness over the left iliac fossa and suprapubic region with no signs of peritonism. Abdominal ultrasonography revealed a left ovarian cyst measuring approximately 8 × 5 cm (suggestive of endometrioma) without septae or echogenicity or any surface excrescences. Color Doppler examination of the cyst revealed no abnormal vasculature. The right ovary and uterus was normal in appearance and there was no ascites. Preoperative CA-125 levels were elevated at 73.7 U/mL but other ovarian tumor markers were within normal limit. The patient was counseled for diagnostic laparoscopy with subsequent ovarian cystectomy.