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Case Reports
. 2023 Apr 19;12(2):116-119.
doi: 10.4103/gmit.gmit_107_22. eCollection 2023 Apr-Jun.

Vaginal Natural Orifice Transluminal Endoscopic Surgery in a Second-trimester Pregnant Woman with an Ovarian Teratoma

Li-Yeh Chen  1 , Dah-Ching Ding  1   2
Affiliations
Case Reports

Vaginal Natural Orifice Transluminal Endoscopic Surgery in a Second-trimester Pregnant Woman with an Ovarian Teratoma

Li-Yeh Chen et al. Gynecol Minim Invasive Ther. .

Abstract

We present the first case of a pregnant woman with teratoma, who underwent vaginal natural orifice transluminal endoscopic surgery (vNOTES). Mature ovarian cystic teratomas compromise 20%-30% of all ovarian tumors. The best surgical management is still unclear, especially during pregnancy. A 21-year-old pregnant woman (gravida 1, para 0) at 14 weeks and 3 days of gestational age was admitted with an intermittent mild sharp and dull pain in her right lower abdomen when walking or moving lower limbs. Pelvic ultrasonography revealed a 5.9 cm × 5.4 cm heterogeneous mass that was suspected as a teratoma in the right adnexa. Initially, laparoendoscopic single-site ovarian cystectomy (OC) was arranged. However, the ovarian tumor was impeded by the enlarged uterus. The OC procedure was changed to vNOTES OC. The vNOTES OC was performed smoothly and the pathology confirmed the mass to be a teratoma. After the operation, she recovered well and was discharged 2 days after the operation without any complication. In conclusion, the application of vNOTES in the second-trimester pregnancy might be considered safe and effective. The vNOTES can be performed safely in selected patients and by an experienced surgeon.

Keywords: Laparoscopy; natural orifice transluminal endoscopic surgery; pregnancy; teratoma.

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Conflict of interest statement

Prof. Dah-Ching Ding, an editorial board member at Gynecology and Minimally Invasive Therapy, had no role in the peer review process of or decision to publish this article. The other author declared no conflicts of interest in writing this paper.

Figures

Figure 1
Figure 1
The ultrasound, laparoscopic, and gross picture of the teratoma. (a) Ultrasound image of teratoma, (b) Laparoscopic image of the right ovarian teratoma, (c) vNOTES view of teratoma, (d) Gross picture of removed teratoma (hair in the teratoma). vNOTES: Vaginal natural orifice transluminal endoscopic surgery
See this image and copyright information in PMC

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