Ovarian cystectomy is a surgical procedure performed to remove cysts from the ovary while preserving healthy ovarian tissue. It is a key fertility-preserving treatment for women with symptomatic ovarian cysts and is commonly indicated when cysts are persistent, enlarging, painful, hormonally active, or suspicious on imaging. The goal of ovarian cystectomy is to eliminate the cyst, relieve symptoms, and maintain ovarian function and reproductive potential.

Ovarian cysts are fluid- or tissue-filled sacs that develop within or on the surface of the ovary. While many cysts are functional and resolve spontaneously, others may persist or cause complications. Common types include functional cysts, endometriomas, dermoid cysts, and benign epithelial cysts. Symptoms prompting surgical management include pelvic pain, abdominal bloating, pressure symptoms on the bladder or bowel, menstrual irregularities, and infertility. Acute complications such as ovarian torsion or cyst rupture may necessitate urgent intervention.

Preoperative evaluation involves detailed clinical assessment, pelvic imaging, and risk stratification to determine cyst characteristics and malignancy risk. Surgical planning focuses on cyst size, location, laterality, patient age, fertility goals, and prior surgical history. Preserving normal ovarian tissue is particularly important in reproductive-age women to maintain hormonal balance and future fertility.

Ovarian cystectomy is most commonly performed using minimally invasive techniques, including laparoscopy, which allows precise cyst removal through small incisions with minimal disruption to surrounding structures. During surgery, the cyst wall is carefully separated from normal ovarian tissue, minimizing damage to the ovarian cortex. In selected cases, open surgery may be required, particularly for very large cysts or when malignancy cannot be excluded.

The advantages of laparoscopic ovarian cystectomy include reduced postoperative pain, shorter hospital stay, faster recovery, and minimal scarring. Preservation of ovarian tissue supports continued ovulation and hormonal function. Careful surgical technique reduces the risk of adhesions, which can otherwise affect fertility and pelvic organ mobility.

Postoperative care includes pain management, monitoring for bleeding or infection, and follow-up imaging when indicated. Recovery time is typically short, and most patients resume normal activities within a few weeks. Fertility counseling may be provided, particularly for women with recurrent cysts or endometriosis-related disease.

Ovarian cystectomy is an effective and fertility-conserving surgical option that addresses both symptoms and long-term reproductive health. When performed with precision and appropriate patient selection, it offers excellent outcomes and significant improvement in quality of life.