Unexpected Benefit of the Laparoscopic Approach to a Complex Neonatal Ovarian Cyst

Abstract

The use of prenatal ultrasonography has unearthed an abundance of fetal ovarian cysts. Many are asymptomatic and not palpable in the newborn. Most resolve spontaneously. Symptomatic cysts require treatment. Many authors advocate intervention for asymptomatic neonatal ovarian cysts recognized by sonography if the image shows a complex cyst, suggesting adnexal torsion, or a simple cyst more than 5 cm in diameter. The method by which ovarian cysts should be treated is debated in the literature. The authors report a case of an asymptomatic complex ovarian cyst because it highlights several benefits of approaching this lesion laparoscopically. The method allowed visualization of both ovaries and revealed unexpected bilateral inguinal hernias. Repair of the hernias prevented future injury to the remaining ovary from incarceration, and the patent hernia sac served as an atypical but convenient site for extraction of the infarcted adnexa.