Valentina Pastore, MD, Angela Basile, MD, Raffaella Cocomazzi, MD, Fabio Bartoli, MD
Pediatric Surgery Unit, University of Foggia, Foggia, Italy (all authors).
Introduction: Minimally invasive surgery is normally used in children but is not so common in newborns, especially those with very low birth weight, as a consequence of an immature cardiopulmonary system and technical difficulties.
Case Description: A preterm female with very low birth weight (1.4 kg), born in the 32nd week of gestation with a prenatal diagnosis of abdominal cyst, presented with distension of the abdomen and a palpable tension mass in the right iliac and hypochondriac region on the first day of postnatal life. Clinical investigation findings indicated a suspected simple right-side ovarian cyst measuring 5.4 8.55 8.72 cm occupying most of the abdomen. The patient’s clinical condition deteriorated quickly with respiratory distress due to the mass’s effect. The cyst was surgically aspirated, isolated, and removed by a completely laparoscopic approach. The operating time was 30 minutes, the respiratory distress resolved immediately, and the patient’s recovery was uneventful.
Discussion: Ovarian cysts are the most common ovarian lesions in newborns; they are usually simple and benign but can be complicated and symptomatic. Minimally invasive surgery is nowadays the gold standard for newborns and children with ovarian cysts, even when complications occur. Furthermore, we have shown that laparoscopy also can be used safely in distressed preterm very low–birth weight newborns without cardiorespiratory consequences, anesthetic incidents, or hypothermia.
Key Words: Ovarian cyst, VLBW, Laparoscopy.