Transumbilical 1-port laparoscopic resection of benign ovarian tumor.
OBJECTIVE
We evaluated the effectiveness of transumbilical 1-port laparoscopic resection of benign ovarian tumors in children with limited working space.


METHODS
This study involved 15 children and adolescents with benign ovarian tumors treated from January 2006 to December 2010. Preoperative evaluation included physical findings, tumor markers, and imaging studies. A single surgeon performed the procedure using a 10-mm 0° operative laparoscope with a 5-mm working channel. The fallopian tube was suspended with transabdominal suspensory sutures passing through the mesosalpinx to expose the tumor and remove it after aspiration of the contents. The tumor was contained in the endobag and chopped into pieces before removal through the small umbilical wound.


RESULTS
The patients' age ranged from 2 to 17 years (mean, 9.7 years). Tumor size ranged from 3.6 to 23 cm. Tumor markers including α-fetoprotein, β-human chorionic gonadotropin, cancer antigen 125, and carcinoembryonic antigen were negative. The average operating time was 134 minutes. Except for 1 patient with associated encephalomyelitis, all patients were discharged within 3 days after surgery. Pathologic examination and follow-up studies revealed benign tumors, with no residual lesions in the abdomen or recurrence.


CONCLUSIONS
Transumbilical 1-port laparoscopic resection is effective for resection of benign ovarian tumors in children, with a satisfactory cosmetic outcome. However, to prevent inadequate resection of a potential malignant lesion, thorough preoperative evaluation with physical signs, tumor markers, and imaging studies, as well as flexible intraoperative tactics, should be adopted.
Department of Pediatric Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Shin-Yi
SY
Lee
Hui-Ming
HM
Lee
Chun-Yu
CY
Kao
Jiin-Haur
JH
Chuang
D000293:Adolescent; D014408:Biomarkers, Tumor / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D018291:Cystadenoma, Mucinous / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D018293:Cystadenoma, Serous / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D061646:Operative Time; D010048:Ovarian Cysts / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*; D013724:Teratoma / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D016896:Treatment Outcome; D014472:Umbilicus
D014408:Biomarkers, Tumor