Hi there,
Ovarian cysts may be present without women being aware of them as they can often be asymptomatic. When an ovarian cyst enlarges though, women may then start complaining of abdominal distention and pain, so this is usually the time that women start to see a gynaecologist for an ultrasound scan. Surgical removal of the cyst is usually recommended when the pain is severe and frequent.
The cyst removal (cystectomy) can be performed via laparoscopy (keyhole surgery) or laparotomy (open surgery) depending on the nature of the cyst (benign or malignant) and the gynecologists' surgical skills.
I hope this helps and I wish you all the best in your treatment journey!