OBJECTIVE
The aim of this study is to determine the feasibility and safety of a robotic approach for the surgical treatment of mature cystic ovarian teratoma using the new Versius robotic platform from CMR (UK).
MATERIAL AND METHODS
The article presents a description of a clinical case of robot-assisted treatment of mature ovarian teratoma in a patient aged 13 years. Indications for surgical treatment of ovarian teratoma were based on clinical symptoms of pelvic discomfort and abdominal pain, as well as ultrasound and magnetic resonance imaging data, which indicated the presence of a cystic tumor formation located in the tissue of the left ovary. The technique of the operation consisted in the enucleation of the inner lining of the cyst. The study used the Versius robotic system manufactured by CMR (UK). The robotic instruments used were a Maryland bipolar forceps and a monopolar coagulator hook and one laparoscopic accessory cannula for assisting instruments. Dispensary observation of the patient was carried out on the 7th, 30th, 90th day of the postoperative period and was accompanied by ultrasonographic control in order to detect recurrence and control the compensatory growth of ovarian tissue.
RESULTS
The diameter of the teratoma, measured before surgery using ultrasound and MRI, was 8.02—7.54—8.11 mm. The teratoma was located in the left ovary. An increase in the concentration of tumor markers was not registered before the operation. The duration of the operation was 70 minutes. There were no complications during the surgical intervention. Histological examination confirmed the presence of mature teratoma in all specimens without signs of malignancy. The duration of the patient’s stay in the hospital was 3 days. There was a disappearance of symptoms associated with pain and discomfort in the abdominal cavity throughout the observation period. Ultrasound performed 1 and 3 months after surgery showed no signs of disease recurrence. 90 days after the procedure, regeneration of the ovarian tissue was noted, comparable to the size of the contralateral ovary.
CONCLUSION
The present study found that the robotic approach can be used in the treatment of mature cystic ovarian teratomas in children, with acceptable functional results. Future research will determine the place of robots in pediatric oncogynecology.