9cm ovar, cyst w/ septations Laparotomy or oscopy?

[ottap]

F-44, no children.  I have been found to have a 9cm cyst on my left ovary with septations (after two very painful episodes).  CA-125 of 59.
Oncologist stated low risk for cancer. I have been referred back to my OB/Gyn for surgery with oncologist as stand by.
I am a very active person/triathlete.  My OB/Gyn in a brief conversation so far gave me the option of a laparotomy or a Laparoscopy to remove the L ovary with cyst and F-tube - stating risk of rupture (no % given), but I need to decide.
Wondering from another OB/Gyn surgeon's perspective which type of procedure would be recommended.
I expected by OB/Gyn to make the call, but it is somewhat on my plate.
Thank you!

[Annekathryn Goodman, M.D.]

Hi There,
It is always reasonable to start with a laparoscopy and then decide at that time if it is necessary to make a bigger incision.
It maybe that this 9 cm cyst is a benign cyst full of water, the water can be drained and the cyst and or whole ovary can be removed through a small incision.

On the other hand, if at laparoscopy, the cyst is stuck to other structures with adhesions or it looks more solid, an incision can be made.
I hope everything works out
best wishes

[doublek180]

A related discussion, could it be a endometrium cyst? was started.

[ottap]

Thank you for your reply to my post (and all the others!)
I will also ask my doctor, but is a tissue sample taken from the cyst and assessed by pathology before it is removed in a laparoscopy? I was thinking not, and that "messing" with it could cause it to burst. I have been asked to weigh the risk of rupture of a malignant cyst via laparoscopy vs. less chance of rupture via laparotomy.  I was working off the thought that you can't find out about benign/malignant until after removal.  I may be thinking through this too much, but goes with the territory.
Thank you!