Laparoscopic oophorectomy in children

Laparoscopy is a well-established diagnostic and therapeutic modality for adult gynecologic surgery. We have sought to assess the feasibility of the laparoscopic approach to a particular gynecologic procedure, oophorectomy, in the pediatric population. Five patients under-went laparoscopic oophorectomy during the past year. The indication for oophorectomy in three cases was ovarian torsion---one in association with a hemorrhagic cyst another with a benign teratoma, and one that occurred prenatally. The fourth patient had a teratoma with significant solid component and the final patient was a young with Turner's syndrome who had laparoscopic exploration and removal of bilateral streak ovaries. Oophorectomy was successfully completed laparoscopically in each patient. In two cases a trocar site had to be widened to remove the specimen from the abdominal cavity. Post operative recovery was prompt, with time to discharge being an average of 2 days. From this experience we conclude that laparoscopic oophorectomy can be successfully accomplished in infants and children. It is technically an easy procedure and has the benefits of excellent visualization of the entire lower abdomen and pelvis including the contralateral ovary, rapid postoperative recovery, and good cosmetic result.