Laparoscopic surgery for gonadal dysgenesis in children

Three pediatric phenotypic females presented with gonadal dysgenesis. Their gonads were removed laparoscopically. These phenotypically normal females, who do not have any intersex problems or ambiguous genitalia, represent a unique group of patients having a Y chromosome or a fragment of it in their genetic constitutions. We performed laparoscopic adnexectomy with Endoloop ligatures or an ultrasonically activated scalpel. No significant complication occurred in any of the cases. Pathologic examination revealed gonadoblastoma in one of the gonads of one patient. We propose that laparoscopic surgery is a safe and minimally invasive procedure for prophylactic gonadectomy to prevent neoplasia, even when performed on pediatric patients.