Single-Incision Pediatric Endosurgical Approach to Right Ovarian Torsion in a 9-Year-Old Girl

Abstract

Background and Objectives: Despite being pioneered by gynecologists, single-incision endosurgery has not been widely reported for the treatment of ovarian and adnexal pathology in neonates, children, and adolescents. We describe our initial experience using single-incision pediatric endosurgery (SIPES) for these indications and discuss advantages and drawbacks. Video: This video shows a single-incision pediatric endosurgical approach to right ovarian torsion in a 9-year-old girl. The instrument is introduced through the umbilicus, grasps the ovary, and performs a counter clockwise derotation of the ovary into anatomic position. Once this is achieved, the ovary is pexied to the round ligament that is overlying the iliac vessels. This fixation of the ovary in an additional point should prevent torsion in the future. Intracorporeal knot tying is performed by using the needle as an angulation device to wrap the suture around the instrument and then lay down the knot. There were no peri- or postoperative complications. The girl was discharged on the first postoperative day. On follow-up 3 months postsurgery, the girl was without complaints. Conclusion: SIPES is an excellent alternative to conventional laparoscopy for the treatment of adnexal pathology. Using a single umbilical incision that can be enlarged instead of three smaller trocar sites facilitates the resection and extraction of ovarian masses without compromising cosmesis. No competing financial interests exist. Runtime of video: 2 mins 56 secs