Gargiulo AR - This study is performed to depict a technique for robot-assisted laparoscopic excision of ovarian dermoid cysts within an endoscopy specimen pouch. They scrutinize video footage of two surgical cases with different size dermoid cysts. Current evidence suggests that excision of dermoid cysts in a contained system can prevent the rare complication of chemical peritonitis. This video provides the first description of a robot-assisted excision of ovarian dermoid cysts carried out completely within an endoscopic specimen pouch. They also elaborate on certain aspects of robot-assisted surgery that may make this operation easier to adopt compared to its conventional laparoscopic counterpart.

• Excision of ovarian dermoid cysts is mostly performed laparoscopically.
• Current evidence indicates that: 1) spillage of cyst material amid laparoscopic dermoid cystectomy is extremely common; 2) such spillage carries the potential of iatrogenic chemical peritonitis; 3) dermoid cystectomy performed within an endoscopic specimen pouch can prevent this complication.
• The available proof ought to persuade surgeons to remove most dermoid cysts in a containment system.
• However, technical challenges do exist in conventional laparoscopy that may limit the adoption of this contained extraction technique.
• They suggest that certain ergonomic features of robot-assisted surgery (namely, the ability to operate effectively within restricted spaces) offer the potential to make this operation approachable to more surgeons.
• This technique employs standard robotic instrumentation and laparoscopically deployed specimen pouches.
• Two cases of fully contained dermoid cyst excisions, performed within a 10-cm diameter and a 15-cm diameter endoscopic specimen pouches, are elucidated.
• The influenced adnexa are placed inside the pouch in both cases, and the entire tumor dissection is performed so that intraperitoneal spillage of cyst fluid and other material is avoided.