Laparoscopy for ovarian pathology in infancy and childhood

Conventionally, adnexal pathology in pediatric patients is treated by open laparotomy. As laparoscopic procedures are constantly finding wider application in pediatric surgery, the female child presenting with a suspected acute or chronic ovarian lesion may be an ideal candidate for laparoscopic surgery. From June 1994 to June 1996, eight girls aged 4 months to 11 years (mean 6.1 years) underwent laparoscopic procedures for various ovarian pathologies at King Khalid University Hospital (7) and Hamad Medical Corporation in Qatar (1). Four children had emergency laparoscopic surgery for lower abdominal crises; three of them were managed successfully for twisted adnexal lesions (2 simple ovarian cysts, 1 benign cystic teratoma), the fourth patient was converted to an open salpingo-oophorectomy. The other four patients had elective laparoscopic excision of adnexal lesions (two antenatally diagnosed ovarian cysts and two mature ovarian cystic teratomas). There were no operative complications; the mean operative time was 76.25 min, the mean hospital stay 2.25 days. Our initial experience and technique are presented. It appears that the laparoscopic approach to ovarian lesions in infancy and childhood is an effective and safe method for diagnosis as well as definitive therapy.