Special Surgical Procedures II
LESSON 2: Procedures in Gynecological and Obstetrical Surgery
Section Ii:
2-30
2-30. EXCISION OF BARTHOLIN DUCT CYST OR ABSCESS
a. General. This procedure consists of removing or incising and draining the cyst through the vaginal outlet. A cyst in the vulvo- vaginal gland usually follows acute infection and is treated by marsupialization when it is quiescent. Such cysts are nonneoplastic and result from retention of glandular secretions due to blockage somewhere in the duct system.
b. Operative Procedure.
(1) The labia minora are sutured to the perineal skin on each side to expose the vaginal introitus. Silk or plain gut sutures swaged to 3/8-circle, cutting edge needles on a needle holder, tissue forceps, and suture scissors are needed.
(2) An elliptical incision is made in the mucosa, which is distended over the cyst.
(3) The cyst wall is dissected and blunt-pointed scissors are used for complete removal of the gland. A drain may be inserted, and a dressing or perineal pad is applied.
