Some ovarian cysts are more complex than others. If your doctor saw solid components to the cyst then they were right to operate. You did not say how old your wife was or whether or not the cyst was causing her pain or other problems. Dense adhesions, which is another name for scar tissue, can make it difficult to safely preform laparoscopic surgery. That is why laparotomy was necessary. otherwise the bowel or bladder could have been seriously injured. Unfortunately adhesions cannot be detected ahead of time. It must be frustrating not to have a more specific diagnosis. Were the doctors able to give you any more info about the cause of the cyst? There is a fairly common condition called endometriosis which produces pain and scarring in the abdomen and pelvis. Sometimes blood accumulates in ovarian cysts. Without a pathology report report it is impossible to say more however it sounds like she received appropriate care. I am glad there was no malignancy. The list of causes of ovarian cysts and adhesions is very lengthy. Adhesions form in reaction to irritation from infection, but also frm endometriosis, parasites, IUD, cancer, etc. etc. .The I adhesions must ve been quite bad to have suspected tuberculosis. i m glad that wasn t it. I wish her a speedy recovery.