Destruction and Repair of Ovarian Tumor Resection (III)

  Surgical disruption and repair are most fully reflected in the traditional open management of benign ovarian tumors. Traditional open surgery to remove benign ovarian tumors involves re-suturing the remaining normal ovarian cortex to form a new ovary. Removal of the tumor is destructive; suturing is repair.  Because the remaining ovarian cortex will bleed more or less, the main purpose of suturing is to stop the bleeding, and secondly, the surgeon believes that the suturing will prevent the injured ovary from adhering to the surrounding organs. We gynecologists have always been convinced of this and have performed this surgical procedure without fail and in a step-by-step manner. It was not until laparoscopic surgery became popular in gynecology that gynecologists discovered that laparoscopic removal of benign ovarian tumors, most of the time with almost no bleeding, was suture repair still necessary?  After a period of observation, the suture-repaired ovaries are more likely to adhere than the non-suture-repaired ovaries, and the non-suture-repaired ovaries will close and repair on their own. Therefore, the sutures are no longer needed for the non-bleeding injured ovaries, and the hemostatic sponge is used to stop the bleeding for the injured ovaries with bleeding, and the sutures are also no longer needed. For bleeding injured ovaries, it is better to stop the bleeding with sutures, because the effect of hemostasis with hemostatic sponges is not enough, and the damage to the remaining ovarian cortex by bipolar electrocoagulation is greater than that by sutures, which even leads to the loss of function of the injured ovary.  It is evident that avoiding bleeding as much as possible when removing the tumor is the key to radically reduce the damage of the surgery. Allowing the injured ovary to repair itself is the only way to avoid secondary damage, and doing nothing is better than doing something.