Abstract
Introduction:
Single-incision laparoscopic surgery has developed as an alternative surgical procedure to reduce postoperative pain and abdominal scarring. Application of this surgical approach is limited in pediatric patients because of lack of surgical expertise and need for specialized instruments. We describe a case in which a giant ovarian serous cystadenoma was excised through a single-transumbilical incision using conventional laparoscopic instruments.
Materials and Methods:
The patient is a 16-year-old girl who presented with a suspected pregnancy because of progressive lower abdominal distention. Imaging demonstrated a 22-cm cystic mass arising from the right adnexa. Alpha-fetoprotein and beta-human chorionic gonadotropin levels were normal. Through a 2-cm transumbilical incision, 7 L of serous fluid was aspirated from the cyst. The puncture site was oversewn and the cyst was returned to the peritoneal cavity through the incision. A TriPort system (Olympus; Center Valley, PA) single-incision platform was placed through the 2-cm incision. An ovarian preserving cystectomy was then performed using electrocautery and Maryland dissector.
Results:
There were no intraoperative or postoperative complications. Operative time was 70 minutes. The patient recovered uneventfully and was discharged home on postoperative day 1. Postoperatively, no abdominal scars were visible. At 4-month follow-up the patient was free of recurrence.
Conclusion:
Ovarian-preserving cystectomy for benign lesions of the ovary can be safely performed through a single-transumbilical incision with standard laparoscopic instrumentation. The procedure is also technically feasible and confers an excellent cosmetic result.
The authors have nothing to disclose.
Presented at the International Pediatric Endosurgery Group's 20th Annual Congress of Endosurgery in Children, May 3–7, 2011, Prague, Czech Republic.
Runtime of video: 4 mins 03 secs
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