title: Laparoscopic approach to ovarian mass in children and adolescents: already a standard in therapy.
abstract: BACKGROUND
  Functional cysts, ovarian torsion, and benign neoplasms are the most common ovarian masses among young adolescents. The laparoscopic approach to giant ovarian cysts in the pediatric population maybe difficult due the limited working space and the high risk of spillage. In this paper, we evaluate the role of laparoscopic surgery in the treatment of adnexal disease occurring in young girls.
  
  
  METHODS
  With the approval of the institutional review board, a retrospective chart review(2007-2003) of patients with adnexal disease was conducted.
  
  
  RESULTS
  Overall, 12 patients were evaluated with preoperative imaging, sonography, and magnetic resonance imaging (MRI) scan and laboratory values. None resulted in malignant histology. All resections of ovarian cysts were performed laparoscopically. The outcome was uneventful in all patients.
  
  
  CONCLUSIONS
  Treatment is indicated if the diagnosis is in question, the cyst persists, in the case of ovarian torsion,or if the patient is symptomatic. Laparoscopy is becoming the favored approach by most pediatric surgeons for the treatment of ovarian cysts. All surgical procedures for ovarian cysts should spare functional ovary as much as is technically possible. Simple cysts can be fenestrated, but complex or functional cysts should be excised, with the preservation of the remaining ovary by careful dissection. The laparoscopic approach for adnexal masses can be performed in an acceptable manner, with comparable results to an open approach, plus the cosmetic advantages of minimally invasive surgery, which is an important aspect for the treated patients.
authors.affiliation: Helios Klinik Berlin, Berlin, Germany. jpatinomayer@arcor.de
authors.forename: Jan Patino
authors.initials: JP
authors.lastname: Mayer
authors.forename: Marcos
authors.initials: M
authors.lastname: Bettolli
authors.forename: Andreas
authors.initials: A
authors.lastname: Kolberg-Schwerdt
authors.forename: Michael
authors.initials: M
authors.lastname: Lempe
authors.forename: Frank
authors.initials: F
authors.lastname: Schlesinger
authors.forename: Irina
authors.initials: I
authors.lastname: Hayek
authors.forename: Klaus
authors.initials: K
authors.lastname: Schaarschmidt
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010048:Ovarian Cysts / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome