After learning that their benign ovarian cysts also need surgery, patients are most concerned about two questions: Is the surgery minimally invasive or open? The other question is: Can the tumor be cut down, or do we need to cut the ovaries? Here we will talk about it. Benign cysts are preferred to laparoscopy As you know, laparoscopy is a minimally invasive surgical procedure that is suitable for the surgical treatment of various abdominal organ diseases, of which benign ovarian cysts are one. Generally, laparoscopic surgery only leaves 2~3 small incisions of 0.5~1 cm in the patient’s abdomen, so you don’t have to worry that the surgery will cause big wounds and scars. However, because laparoscopic surgery requires a head-down position to provide the surgeon with a better view of the operation and to reduce adverse symptoms such as headache caused by postoperative anesthesia. However, studies have also shown that head-down and foot-up positions can increase the load on the heart. So patients with cardiovascular diseases such as hypertension and coronary heart disease who cannot tolerate the anesthesia position may need an open abdomen to perform the surgery. Secondly, if the patient has very serious intra-abdominal adhesions due to multiple surgeries, etc., open surgery may also be required. Furthermore, if the preoperative examination considers the mass to be malignant, open surgery is also recommended. In conclusion, if the ovarian cyst is benign and the patient is in good health, laparoscopic treatment is preferred. The surgical options for benign ovarian cysts include debulking (i.e., debulking only the cyst), removal of the affected (unilateral) ovary + fallopian tube, and total removal of the ovary + fallopian tube + uterus bilaterally. What are the factors that determine how the procedure is done? That is the patient’s age, fertility requirements and the morbidity of both ovaries. (1) In young, fertile patients with unilateral benign tumors, the first choice is to remove the affected ovarian mass, but if the mass is so large that it basically destroys all the normal ovarian tissue, then the only option is to remove the affected ovary. The general principle is to preserve the normal ovarian tissue on the affected side and the normal ovary on the opposite side as much as possible. (2) Patients who are young, have fertility requirements and have bilateral benign ovarian tumors should strive for ovarian mass debulking to preserve normal ovarian tissues in order to improve their postoperative quality of life. (3) Women who have reached menopause and do not have fertility requirements can be considered for resection of the affected fallopian tube + ovary or bilateral removal of fallopian tube + ovary + uterus. Therefore, if you are unfortunate enough to have an ovarian cyst, even if it is benign, the sooner the surgery is performed, the less damage to the ovaries. After the mass has destroyed all the normal tissues of the ovary, it will only be too late to regret. Especially for patients who want to have a baby, it is important to follow the doctor’s advice and not to be capricious.