I have a 8.4cm hypoechoic cystic lesion on my ovary. i saw an obgyn who wants to do a lap cystectomy. an oncologist suggested a laparotomy cystectomy. which is more recommended? cyst is complex and possibly endometrioma, hemorhaggic or dermoid.

It depends: It will help us to know your CA 125 level(it is a blood test which is raised in cancer of the ovary). If you have history of Endometriosis, then Laparoscopy may be the preferred test. If your CA 125 level is high, that will increase the suspicion that the cyst could be cancerous....in that case a laparotomy may be the preferred procedure. But remember, laparascopy can be converted into laparotomy

Lap vs open: A laparoscopic approach is the minimally invasive approach. Open cystectomy is an old school way of doing things. Robotic cystectomy may be an option if your facility has one. I personally like the minimally invasive option of laparoscopy/robotic laparoscopy over open approach. Quicker recovery with the same outcomes if surgically equal at both.