Robotic-assisted resection of ovarian tumors in children: A case report

Abstract

BACKGROUNDOvarian tumors are common gynecological diseases in children, and the most commonly seen ovarian tumors are germ cell tumors. Robotic surgery is the new access for children ovarian tumors.CASE SUMMARYFrom June to October 2017, 4 children with ovarian tumors were admitted and treated in the Department of Pediatric Surgery of People’s Liberation Army General Hospital. The mean age, height, and weight of these patients were 7.5 (1-13) years old, 123.75 (71-164) cm, and 36.8 (8.5-69.5) kg, respectively. Robotic-assisted resection of ovarian tumors was performed for all 4 patients. The 3-port approach was used for robotic manipulation. The surgical procedures were as follows. After creation of the pneumoperitoneum, the robotic scope was placed to explore and find the left ovarian tumor. The trocars for robotic arms 1 and 2 were placed at the sites to the lower right and left of the port of the scope. The tumor capsule in the fallopian tube was incised, and the tumor was completely stripped by an electric hook along the junction of the tumor and the capsule. The resected tumor was completely removed using an endobag. The average docking time of the robotic system was 18.5 min, the average operative time was 120 min, and the average blood loss was 20 mL. No drainage tube was placed except in one patient with a mucinous tumor of the ovary. No fever, pelvic fluid, or intestinal obstruction was reported after surgery. No antibiotics were used during the perioperative period, and the average length of hospital stay after surgery was 3 d.CONCLUSIONRobotic-assisted resection of ovarian tumors is a simple, safe, and effective surgical procedure for selected patients.

Robotics-Assisted Pediatric Oncology Surgery—A Preliminary Single-Center Report and a Systematic Review of Published Studies

“…The role of RAS is becoming progressively more important in every field, including pediatric oncology. In the last decade, several papers have been published on the subjects, even if the sample of the cohort is often small since most of the studies are case reports (5)(6)(7)(8)(9)(10)(11)(12). The still limited spread of this technique is due to both the concerns of the use of MIS for tumors and the well-known limitations of RAS in children (13,14).…”

“…In our practice, the first oncological procedures that were performed concerned adnexal lesions, as we believed that RAS is a perfect fit for these indications. Adult gynecology has already proven the feasibility of robotic procedures for both benign and malign pathologies (7,(17)(18)(19)(20), and experience in pediatrics is growing (7,9,21). A robot allows a superb visualization of the pelvis, and in the majority of cases, port placement may be carried out easily, as most girls undergoing this kind of surgery are adolescents.…”

Extirpación laparoscópica de quiste paraovárico gigante en pediatría

“…La progresión tecnológica de la ciencia médica ha permitido la utilización de tecnología robótica para la extirpación de masas anexiales en la edad pediátrica y ha evidenciado ser un procedimiento quirúrgico simple, seguro y eficaz para pacientes seleccionadas 20 .…”

Robotic-Assisted Minimally Invasive Surgery in Children

“…In addition, robotic resection of mature cystic teratoma and mucinous ovarian tumor. It is an easy and safe technique in selected patients and also for the treatment of complex gynecological diseases [128]. Surgeries in the pelvis have a reduced field of work and are ideal for the robotic approach.…”

“…Robotic gynecological surgery in girls with ovarian disease, the ideal is to maintain the morphology of the ovary, which is beneficial for the recovery of postoperative ovarian function, especially in benign diseases. In centers where robotic surgery is available, ovarian tumors are a suitable entry procedure [128].…”