Laparoscopic management of ovarian cysts in infants, children, and adolescents

Patients and Methods: From March 1996 to June 2000, 39 girls aged 2 days to 17 years (mean 14 years) underwent laparoscopy for ovarian pathology at the Department of Pediatric Surgery, University Medical Center, Jena. Three cases were excluded from this analysis because of incomplete clinical data. Laparoscopes with diameters 1.7, 2.0, and 5.0 mm were used in 15, 11, and 10 patients, respectively. Results: The average operating time was 35 minutes (range 17-125 minutes). In seven patients, ovarian cysts were diagnosed in utero. In 25 patients, the right ovary, in eight the left, and in three both ovaries were involved. Needle aspiration was performed in 26 patients. Cysts were enucleated in two patients, and one patient received total ovariectomy. Five patients required a minilaparotomy for the delivery of large tumor masses. In two patients, cysts of <1 cm in diameter were left untreated. No malignancy was noted. Additional intra-abdominal pathology was discovered in 11 patients. There were no intraoperative or post-operative complications. Conclusion: When performed by an experienced operator, laparoscopic treatment of ovarian cysts in children is a safe and beneficial alternative to laparotomy.