Bartholin Gland Duct Marsupialization : A Surgical Procedure

Clinical Pearl: Bartholin Gland Duct Marsupialization

A Surgical Procedure :

For this patient, surgical marsupialization is planned for a recurrent, persistent right Bartholin gland duct cyst. Marsupialization is an outpatient procedure typically performed in an operating suite using a unilateral pudendal nerve block or general anesthesia. The patient is placed in the dorsal lithotomy position, and the vagina and vulva are surgically prepared. Trimming of obstructive pubic hair may be preferred to a perineal shave.

A scalpel is used to incise the skin overlying the cyst. A vertical incision measuring 2 to 3 cm is created using a scalpel with either a 10 or 15 blade. The incision is made on the vestibule near the medial edge of the labia minora and approximately 1 cm lateral and parallel to the hymenal ring. This will allow the final, healed ostium to reflect normal gland duct anatomy. Care is taken to incise the skin, but not to puncture the underlying cyst wall.

The smooth inner cyst wall is seen. The tip of a small hemostat is placed within the drained cavity, and the tips are opened and closed to lyse adhesions or to open loculations within it. The cavity is rinsed with sterile saline and suction is used to remove remaining saline and blood prior to wound closure.

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