With a standard retrieval bag, dermoid cyst contents spilled inside the abdomen in about one in four women; none spilled with a fully enclosed device: multicentre randomised trial
Zhou C, Hou S, Yu H, et al. J Minim Invasive Gynecol. 2026. PMID 42854831 (opens in a new tab) doi:10.1016/j.jmig.2026.10.002 (opens in a new tab)
- Study
- Multicentre randomised superiority trial (NCT04406597) in four academic hospitals in Beijing; 119 premenopausal women aged 18 to 45 with a unilateral ovarian mass of 3 to 10 cm were randomised to cystectomy carried out inside a totally enclosed protective device or to conventional cystectomy with extraction in a standard retrieval bag; 105 were analysed (53 against 52) after exclusions.
- Finding
- Macroscopic spillage inside the abdomen, the primary outcome, occurred in 0 of 53 women with the device against 13 of 52 (25.0%, about one in four) with a standard bag (risk difference -25.0%, 95% CI -36.8% to -13.2%, P<0.001); the cyst ruptured during surgery about as often in both groups (32.1% against 25.0%, risk difference 7.1%, 95% CI -10.3% to 24.5%); operating times were similar and the device deployed successfully every time; over a median 34.5 months, 5 of 52 control women (9.6%, about one in ten) developed new chronic pelvic pain and none of the device group did.
Supports current practice moderate evidence
Avoiding spillage of dermoid contents is standard careful technique and the trial shows why: one in four spills with a conventional bag, and late pelvic pain only in that arm; it is a small trial of a device whose availability outside China is not described, so it supports strict spillage avoidance rather than a particular product.
- What it means
- For a woman having a dermoid cyst removed by keyhole surgery, the useful fact is in the control arm: with a standard retrieval bag the cyst contents spilled inside the abdomen in about one in four, and about one in ten of that group went on to develop long-term pelvic pain, against none when the whole cyst was handled inside a sealed device.
Conflicts of interest: Publicly funded (Capital's Funds for Health Improvement and Research, Beijing, No. 2022-2-406); the device's maker is not named in the record.
Reviewed by Mr Jan, .