When cyst size range from to 4cm and 8 cm, the so-called mixed technique is advised by the CEC. It involves of starting surgery with an attempt at cystectomy remote from the vascular bed of the ovary (the ovarian hilum)(18).
In case of diffuse bleeding, surgery is immediately stopped to avoid the risk of irreversibly altering ovarian function.A 2-stage surgery iis then considered and discussed during the preoperative consultation, but unfortunately cannot be guaranteed.
If there is no diffuse bleeding, the procedure is meticulously continued up to the ovarian hilum. The cyst wall in contact with the hilum is then vaporized with the CO2 laser sso as not to cause unnecessary bleeding in a highly vascularized area(18).
