Single-incision pediatric endosurgery for ovarian pathology.

Abstract

BACKGROUND AND OBJECTIVES:

Despite being pioneered by gynecologists, single-incision endosurgery has not been widely reported for the treatment of ovarian and adnexal pathology in neonates, children, and adolescents. We describe our initial experience using single-incision pediatric endosurgery (SIPES) for these indications and discuss advantages and drawbacks.

SUBJECTS AND METHODS:

All children who underwent SIPES with a preoperative diagnosis of ovarian or adnexal pathology were included in the study. Data on age, operative time, complications, length of hospital stay, and outcomes were collected.

RESULTS:

From January 2010 until January 2012, 19 girls (mean age, 11.4 years; range, 6 days-17 years; weight range, 4.0-90 kg) underwent SIPES procedures for ovarian or adnexal diagnoses, including hemorrhagic/follicular/paratubal cysts (n=8), torsion (n=7), tumor (n=3), and parauterine cyst (n=1). The operations included cyst unroofing (n=4), detorsion and oophoropexy (n=7), (salpingo)oophorectomy (n=5), marsupialization of cyst (n=2), and cyst aspiration (n=1). Median operative time was 42 ± 29 minutes; there were no conversions to conventional laparoscopy or open surgery. Fifteen patients (79%) were discharged within 24 hours after the procedure. There were no peri- or postoperative complications. Histopathology showed hemorrhagic/follicular/paratubal cyst (n=7), necrotic/calcified ovarian tissue after torsion (n=6), cystadenofibroma (n=1), granulosa cell tumor (n=1), and mature teratoma (Grade 0) (n=1).

CONCLUSIONS:

SIPES is an excellent alternative to conventional laparoscopy for the treatment of adnexal pathology. Using a single umbilical incision that can be enlarged instead of three smaller trocar sites facilitates the resection and extraction of ovarian masses without compromising cosmesis.

• Authors: Martin Lacher, Joachim F Kuebler, Govardhana R Yannam, Charles J Aprahamian, Lena Perger, Elizabeth A Beierle, Scott A Anderson, Mike K Chen, Carroll M Harmon, Oliver J Muensterer
• Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A (J Laparoendosc Adv Surg Tech A) Vol. 23 Issue 3 Pg. 291-6 (Mar 2013) ISSN: 1557-9034 [Electronic] United States
• PMID: 23402287 (Publication Type: Journal Article)

Topics

• Adolescent
• Child
• Child, Preschool
• Endoscopy (methods)
• Female
• Gynecologic Surgical Procedures (methods)
• Humans
• Infant
• Infant, Newborn
• Ovarian Diseases (surgery)
• Prospective Studies