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Robotic-Assisted Laparoscopic Approach to Removal of Müllerian Remnants
C A Kebodeaux1, J Appleton2, J E Dietrich1
1Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; Division of Pediatric and Adolescent Gynecology, Department of Pediatric Surgery, Texas Children's Hospital, Houston, Texas.
Journal of Pediatric and Adolescent Gynecology
|July 20, 2021
Summary
Robotic-assisted laparoscopy (RAL) successfully removed Müllerian remnants (MR) in two adolescents with complex anatomy. This minimally invasive approach offers a viable surgical option for challenging cases.
Area of Science:
- Minimally invasive surgery
- Pediatric surgery
- Surgical robotics
Background:
- Robotic-assisted laparoscopy (RAL) presents an alternative to traditional laparoscopy.
- RAL may enhance surgeons' ability to perform minimally invasive removal of Müllerian remnants (MR).
- This approach is particularly relevant for patients with complex anatomical variations.
Observation:
- Two adolescent cases involving complex anatomy and prior surgical history are presented.
- Case 1: A 13-year-old female with VACTERL and a uterine remnant near the ureter of a single kidney.
- Case 2: A 16-year-old female with cloacal exstrophy and omphalocele, featuring remnant hindgut and cervical remnant deep in the pelvis.
Findings:
- Robotic-assisted laparoscopy enabled adequate resection of Müllerian remnants in both cases.
- The surgical procedures were completed without any intraoperative or postoperative complications.
- Successful removal of Müllerian remnants was achieved in both adolescents with complex conditions.
Implications:
- Robotic-assisted laparoscopy is a feasible and safe option for the surgical management of Müllerian remnants in adolescents with complex anatomy.
- This technique may expand the application of minimally invasive surgery in pediatric patients with challenging congenital anomalies.
- Further research into RAL for complex pediatric surgical conditions is warranted.
