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This video presents a rare and educational case of laparoscopic oophorectomy performed in a 3-year-old child, highlighting the role of minimally invasive surgery in pediatric gynecology. The procedure is demonstrated step by step, focusing on safe surgical techniques, precise dissection, and child-specific anatomical considerations.

Laparoscopic oophorectomy in pediatric patients requires advanced expertise due to the small operative field and delicate tissues. This video emphasizes key aspects such as port placement in infants and toddlers, gentle tissue handling, hemostasis, and preservation of surrounding structures, ensuring optimal surgical outcomes with minimal trauma.

Laparoscopy is a well-established diagnostic and therapeutic modality for adult gynecologic surgery. We have sought to assess the feasibility of the laparoscopic approach to a particular gynecologic procedure, oophorectomy, in the pediatric population. This patient underwent laparoscopic oophorectomy. The indication for oophorectomy, in this case, was ovarian torsion in association with a benign teratoma, and that occurred prenatally. The patient had a teratoma with significant solid components. Oophorectomy was successfully completed laparoscopically in the patient. Postoperative recovery was prompt, with time to discharge on the same days. From this experience, we conclude that laparoscopic oophorectomy can be successfully accomplished in infants and children. It is technically an easy procedure and has the benefits of excellent visualization of the entire lower abdomen and pelvis including the contralateral ovary, rapid postoperative recovery, and good cosmetic results.

Laparoscopic oophorectomy, the surgical removal of one or both ovaries, is a standard procedure in adult and adolescent gynecology. However, performing this procedure in very young children, such as a 3-year-old, is extremely rare and requires specialized pediatric surgical expertise. Advances in pediatric minimally invasive surgery have made such procedures safer, less invasive, and associated with faster recovery.

Indications in Pediatric Patients
Oophorectomy in children may be indicated for several reasons, including:

Ovarian cysts or tumors – benign or malignant

Torsion of the ovary – leading to loss of blood supply

Congenital anomalies – rare developmental issues requiring removal

Infections or non-functional ovaries

Early intervention is crucial to prevent complications like rupture, hemorrhage, or loss of ovarian function in the remaining ovary.

Preoperative Evaluation
Prior to surgery, a thorough evaluation is essential:

Imaging: Ultrasound or MRI to assess size, location, and nature of the ovarian lesion

Blood Tests: To check general health, coagulation profile, and tumor markers if indicated

Anesthesia Assessment: Pediatric anesthesiologist involvement is critical for airway management and safe anesthesia in toddlers

Surgical Technique
Laparoscopic surgery in a 3-year-old presents unique challenges due to the small abdominal cavity and delicate tissues. Key steps include:

Port Placement:

Usually 3 ports: one umbilical for the camera and two working ports

Careful positioning to avoid injury to other organs

Insufflation:

Low-pressure CO₂ insufflation (6–8 mmHg) to reduce cardiopulmonary stress

Identification and Dissection:

Gentle handling of ovarian tissue and surrounding structures

Isolation of ovarian vessels using fine bipolar or ultrasonic energy devices

Ovary Removal:

Specimen is retrieved using an endoscopic bag to prevent spillage

Care is taken to preserve the fallopian tube if possible

Closure:

Ports are closed with absorbable sutures

Minimal scarring due to the small size of incisions

Advantages of Laparoscopy in Children

Less postoperative pain

Quicker recovery and early return to normal activity

Reduced risk of adhesion formation

Minimal scarring, which is important for cosmetic and psychological reasons

Postoperative Care

Short hospital stay (often 24–48 hours)

Pain management with pediatric-appropriate medications

Follow-up imaging to monitor the remaining ovary and confirm complete removal

Conclusion
Laparoscopic oophorectomy in a 3-year-old child is a safe and effective procedure when performed by experienced pediatric surgeons. The minimally invasive approach offers significant advantages over traditional open surgery, including faster recovery, less pain, and better cosmetic outcomes. Such cases highlight the importance of specialized pediatric surgical training and the growing role of laparoscopy in even very young patients.

For more information please contact:
World Laparoscopy Hospital
Cyber City, Gurugram, NCR Delhi
INDIA 122002
Phone & WhatsApp: +919811416838, + 91 9999677788