Laparoscopic management of a large ovarian cyst in the neonate

Abstract

Laparotomy has become the preferred approach to the excision of large, complex abdominal cysts in the neonate. We describe a laparoscopic-assisted decapsulation of an antenatally diagnosed abdominal cyst that was noted on postnatal ultrasound scan to have a complex echo pattern. This limited procedure allows for accurate verification of the diagnosis, institution of appropriate therapy, and organ salvage. It represents a superior management option that obviates the significant complications associated with conservative management.

Laparoscopic Management of Synchronous Bilateral Ovarian Torsion in a Neonate

“…The differential diagnosis of a prenatal cystic abdominal mass includes omental cyst, mesenteric cyst, intestinal duplication, urachal cysts, renal cysts and ovarian cysts [1]. Preoperative diagnosis of ovarian torsion is difficult not only in newborns or infants but also in pre pubertal girls.…”

Neonatal ovarian cysts

“…Risk of torsion versus the likelihood of resolution of the cyst, however, is not well established and recently simple cysts up to even 8 cm in diameter have been reported to regress spontaneously (26,27). Current management of these cysts includes observation with ultrasonographic follow-up, ultrasound-guided needle aspiration, surgery such as minimally invasive laparotomy or laparoscopic excision (1,3,4,7,25,28). Early intervention has been recommended to avoid complications and allow preservation of ovarian tissue.…”