Design: N/A

Setting: OR setting involved both patients in dorsal lithotomy, arms tucked. The primary surgeon was on the patient's right side, the first assist on the patient's left side. The second assist was driving the uterine manipulator.

Patients or Participants: 2 patients were part of this video. They were seen through our clinic, and were deemed suitable candidates for this procedure. They had pre-operative imaging, bloodwork, and tumor marker screening, and were both suspected to have benign cysts.

Interventions: Both patient underwent a laparoscopic direct trocar drainage of their benign cyst successfully. Patient #1 then underwent a laparoscopic right salpingo-oophorectomy. Patient #2 underwent a laparoscopic bilateral salpingo-oophorectomy.

Measurements and Main Results: No cyst spillage was noted in either of the cases. No conversion to laparotomy was required. Both patients recovered well and had an uncomplicated post operative course.

Conclusion: The direct trocar technique through a laparoscopic approach is a simple, effective, and rapid way of large cyst decompression and drainage without spillage. Compared to other techniques, this technique is cost effective, quick, and prevents an open laparotomy. This technique can be used safely for patients with large benign adnexal masses.