Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42？cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1–12 liters were drained from the cysts (mean 5.2？L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy. 1. Introduction Ovarian neoplasms are a common clinical problem affecting women of all age groups. They are the fourth most common reason for gynecologic admission in the United States, and it has been estimated that approximately 10% of women in the United States will undergo surgical procedure for a suspected ovarian neoplasm during their lifetime [1]. Laparoscopy is considered the gold standard approach to manage benign ovarian cysts. The benefits of laparoscopy include reduced postoperative analgesic requirement, earlier mobilization reducing chances of deep venous thrombosis (DVT), cosmetic advantages, earlier discharge from the hospital, and return to normal activity. A major factor that will make the gynecologic surgeon decide to perform a laparotomy is the size of the ovarian mass. The definition of huge ovarian cysts is not well described in the literature. Some authors define large ovarian cysts as those that are more than 10？cm in diameter as measured by preoperative scans [2]. Others define large ovarian cysts as those that are reaching above the umbilicus [3]. Laparoscopic management of huge ovarian cysts has been described in previous case reports [4–11]. Despite this, most patients with huge ovarian
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