Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Dec 26, 2017; 7(4): 148-150
Published online Dec 26, 2017. doi: 10.5662/wjm.v7.i4.148
Laparoscopic-extracorporeal surgery performed with a fixation device for adnexal masses complicating pregnancy: Report of two cases
Hanako Kasahara, Iwaho Kikuchi, Aya Otsuka, Yoko Tsuzuki, Michio Nojima, Koyo Yoshida
Hanako Kasahara, Iwaho Kikuchi, Aya Otsuka, Yoko Tsuzuki, Michio Nojima, Koyo Yoshida, Department of Obstetrics and Gynecology, Juntendo University Urayasu Hospital, Chiba 279-0021, Japan
Author contributions: Kasahara H and Kikuchi I contributed equally to this work; Kasahara H, Kikuchi I, Otsuka A and Tsuzuki Y performed the research; Kikuchi I designed the research; Nojima M and Yoshida K conducted the research; Kasahara H wrote the paper.
Informed consent statement: Because the patients have moved, we could not contact them. Before the operation, we have got comprehensive agreement, so the IRB approved.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Iwaho Kikuchi, MD, PhD, Department of Obstetrics and Gynecology, Juntendo University Urayasu Hospital, Tomioka 2-1-1, Urayasu City, Chiba 279-0021, Japan. kikuchi@juntendo.ac.jp
Telephone: +81-47-3533111 Fax: +81-47-3520187
Received: January 16, 2017
Peer-review started: January 18, 2017
First decision: March 27, 2017
Revised: November 18, 2017
Accepted: December 1, 2017
Article in press: December 1, 2017
Published online: December 26, 2017
Processing time: 343 Days and 13.6 Hours
Abstract

The potential complications associated with an adnexal mass discovered during early pregnancy call for surgical treatment. Ideally, surgery is performed after gestational week 12, but uterine expansion after the first trimester makes surgery difficult. We report two pregnancies complicated by adnexal masses for which we used an organ fixation device for safe performance of single-site umbilical laparoscopic surgery. Pelvic magnetic resonance imaging depicted a dichorionic, diamniotic twin pregnancy and 60-mm right adnexal mass in the first patient and bilateral adnexae in the second. All three masses were suspected mature cystic teratomas. Both patients underwent laparoscopic surgery during gestational week 14. With use of an organ fixation device, traction was applied until the mass reached the umbilicus; tumor resection was performed extracorporeally. In the second patient, the second mass was simply aspirated because adhesions were encountered. Our single-site laparoscopic-extracorporeal technique proved to be a safe approach to an otherwise high-risk situation.

Keywords: Laparoscopic surgery; Pregnant complication; Ovarian mass; Fixation device; Extracorporeal

Core tip: The new device, “Ova-Lead” has a 20-mm-diameter tip that is made of silicone and shaped like a suction cup. It fixes to the organ through the application of negative pressure, by using this device the surgeon manipulates the organ. We reported two cases of adnexal mass discovered during pregnant that this device seemed useful.