Treatment is indicated if the diagnosis is in question, the cyst persists, in the case of ovarian torsion,or if the patient is symptomatic. Laparoscopy is becoming the favored approach by most pediatric surgeons for the treatment of ovarian cysts. All surgical procedures for ovarian cysts should spare functional ovary as much as is technically possible. Simple cysts can be fenestrated, but complex or functional cysts should be excised, with the preservation of the remaining ovary by careful dissection. The laparoscopic approach for adnexal masses can be performed in an acceptable manner, with comparable results to an open approach, plus the cosmetic advantages of minimally invasive surgery, which is an important aspect for the treated patients.

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