Minimal access surgery in adolescent gynaecology

Pandis, GK; Michala, Lina; Creighton, SM; Cutner, A.

doi:10.1111/j.1471-0528.2008.01995.x

Cited by 19 publications

(5 citation statements)

References 34 publications

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“…However, as would be the case with adults, it is important to consider a paediatric patient’s suitability for a laparoscopic procedure. Laparoscopy in children and adolescents requires the surgeon and anaesthetist to have knowledge of the various anatomical differences noted in children and adolescents compared with adults (Table ) …”

Section: Managementmentioning

confidence: 99%

Management of ovarian cysts in children and adolescents

Potdar

Pillai

Oppenheimer

2020

The Obstetric & Gynaecologis

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Key content Most ovarian cysts in children and adolescents are benign. Incidence of large ovarian cysts usually peaks in the first year of life and around menarche; approximately 30% of girls will present with pain. Gynaecologists, paediatric surgeons and general surgeons may manage ovarian cysts. There is a lack of standardised protocols and guidance, so most patients are managed on the basis of an individual clinician’s judgement, preference and experience. Whenever possible, the operation of choice for benign cysts is laparoscopic ovarian cystectomy with ovarian preservation. This review provides an evidence‐based tool for the management of ovarian cysts in children and adolescent girls. Learning objectives To identify ovarian pathology using appropriate imaging in emergency and elective situations. To know that, when possible, a multidisciplinary approach between gynaecologists, radiologists and paediatric surgeons is optimal. To be vigilant for malignant tumours and perform ovarian‐sparing surgery for suspected benign conditions. Ethical issues There are long‐term reproductive consequences of inadvertently removing one or both ovaries. Unnecessary surgery has an effect on patients’ physical and mental wellbeing.

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Section: Managementmentioning

confidence: 99%

Management of ovarian cysts in children and adolescents

Potdar

Pillai

Oppenheimer

2020

The Obstetric & Gynaecologis

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“…approach, having the advantages of less bleeding and post-operative pain in addition to shorter hospital stay, faster recovery and better cosmetic outcome (Soong et al, 1996). These merits are specifically important in adolescent patients in whom cosmesis may be very important and a faster recovery would allow for earlier return to school (Pandis et al, 2009). The use of bowel segments, reported as early as 1892 by Sneguireff, has gained enormous popularity for vaginal reconstruction in DSD and is also widely used following pelvic exenteration for cancer .…”

Section: Vaginoplasty Techniquesmentioning

confidence: 99%

An update on surgical and non-surgical treatments for vaginal hypoplasia

Callens

Cuypere

Sutter

et al. 2014

Human Reproduction Update

174

168

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As the medical literature lacks high-quality comparative outcome studies and prospective, longitudinal studies are scarce, no evidence-based treatment guidelines can be provided. However, because of the physically low complication rate and an overall success chance of 75%, vaginal dilation as first choice treatment seems to be justified. Overall, the laparoscopic Vecchietti procedure, becoming more and more available in specialized centres, is considered an appropriate surgical option in patients who are poorly compliant and failed dilation therapy, or for those who do not want to start with vaginal dilation therapy. Future approaches need to raise a wider range of psychosexually oriented questions, elucidate the relationship between vaginal depth and satisfactory outcomes and gain additional experience concerning the format of acceptable and efficient psychological care.

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“…Minimal access surgery in adolescents should be performed by highly competent surgeons, particularly when complex congenital anomalies or advanced endometriosis is suspected. 16,17 Among open surgeries, a suprapubic transverse incision is advantaged by lower postoperative pain, less risk of long-term hernia complications, and better cosmesis. However, massive abdominopelvic masses and suspected malignancy do require longer midline longitudinal incisions for complete exploration.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Gynecological Surgeries: Cause for Concern

Anant

Sharma

Jha

et al. 2022

IJRSMS

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Introduction Gynecological surgery in adolescent girls (10–19 years) remains challenging due to remarkable differences in anatomy, physiology and need for fertility preserving conservative surgical approach. We aimed to identify the various gynecological causes, operative outcomes, and need for follow-up surgeries in adolescents. Methods A single-center hospital record-based retrospective study was conducted for gynecological surgeries performed on adolescents in a 5-year period with exclusion of obstetrical and nongynecological causes. Results Sixty-eight adolescents of mean age 16.77 ± 2.317 years underwent gynecological procedures wherein 63 (92.64%) were postmenarchal girls. Pain abdomen (75%), menstrual abnormality (47%), and abdominal swelling (47%) were their main complaints. Note that 35 (51.4%) surgeries performed were for adnexal masses and 24 (35.3%) for obstructive Mullerian anomalies or neovagina creation. Other indicated surgeries were uterine leiomyoma (4.4%), Bartholin's cyst (5.8%), and pelvic abscess (1.4%). The mean interval of symptoms to the diagnosis was 1.22 ± 1.381 years while the mean diagnosis to surgery interval was 8.71 ± 5.880 days. A statistically significant difference (243.3 vs. 783.1 days, p < 0.00001) was found in the symptoms to diagnosis interval and the length of hospital stay (difference in means 16 days, p < 0.00001) in the two major operative groups. Minimal access surgery could be completed in 37% of cases. Complications encountered were bowel injury in 5.8%, bladder injury in 2.9%, blood transfusion requirement in 5.8%, and reoperation in 2.94%. Follow-up revealed one death, adjuvant chemotherapy in 7.3%, and suppressive hormone therapy for endometriosis in 13% of operated girls. Conclusion Diagnosis of a gynecological presentation is protracted and delayed in adolescents. Both diagnosis and surgery is challenging, and minimal invasive surgery is preferable. Malignancy diagnosis or exclusion, treatment, and follow-up should be prioritized to limit delays in the decision to treat. Timely and appropriate, as far as possible conservative surgery and adherence to follow-up protocols will ensure successful outcomes.

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Minimal access surgery in adolescent gynaecology

Cited by 19 publications

References 34 publications

Management of ovarian cysts in children and adolescents

Management of ovarian cysts in children and adolescents

An update on surgical and non-surgical treatments for vaginal hypoplasia

Adolescent Gynecological Surgeries: Cause for Concern

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