Improving minimally invasive surgical approaches to large adnexal masses in pediatric gynecology: combining mini-laparotomy with single port laparoscopy.

In pediatric populations large ovarian cysts are often benign, and minimally invasive approaches are preferred to minimize perioperative pain and recovery, allow for same day discharge, and improve incision cosmesis. Ovarian preservation is also prioritized and cystectomy is preferred over oophorectomy. While tactile sensation and dexterity are improved in mini laparotomy cases, there are limitations with visualization that are improved with laparoscopy. We describe a technique that employs both diagnostic laparoscopy and mini laparotomy using the GelPOINT Mini™ Advanced Access Platform for single site laparoscopy in pediatric patients. This case series includes cysts ranging 7-24 cm with benign preoperative risk stratification, in patients aged 3 to 16 years, who underwent successful same-day, ovarian-sparing surgery with the benefits of both open and laparoscopic procedures.