The use of laparoscopy in the management of adnexal pathologies in children

Background: The authors' experience of using laparoscopy in the management of 23 girls (mean age: 8.9 years; range: 3 months-15 years) with various ad nexal pathologies over a 3-year period is reviewed. Methods: Of the 23 patients, seven were evaluated for congenital gonadal pa thologies, 15 presented with abdominal pain and one patient had an antenata lly diagnosed adnexal mass. Detailed laparoscopic examination of the pelvic cavity and laparoscopic gonadectomy were successfully performed in all sev en patients with congenital gonadal pathologies: mosaic Turner's syndrome ( n = 2), gonadal dysgenesis (n = 3) and testicular feminization syndrome (n = 2). Of 15 patients presenting with abdominal pain, 11 had an adnexal mass , two had acute appendicitis and two had pelvic inflammatory disease. Results: Laparoscopic excision of the adnexal masses were successfully perf ormed in 10 of 11 patients. Conversion to open surgery was required in one patient with a huge teratoma. Laparoscopic appendicectomy was successfully performed in both patients with acute appendicitis while diagnostic laparos copy was the only procedure required in the two patients with pelvic inflam matory disease. Laparoscopy in the infant with an antenatally diagnosed adn exal mass confirmed this to be an omental cyst, which was successfully exci sed. All patients recovered without complications and good cosmetic result was universally achieved. Conclusion: Laparoscopy is safe and effective in both diagnosis and treatme nt of adnexal pathologies in children.