IPEG 2020 Top Abstract: Laparoscopic Assisted Excision of a Type III Sacrococcygeal Teratoma

September 30, 2020
Presenter: Jerry Xiao, BA

Jerry Xiao, BA1; Veronica Sullins, MD2; Shannon Koehler, MD, PhD3; John Aiken1; Marjorie Arca4; 1Medical College of Wisconsin; 2UCLA Health; 3Driscoll Children's Hospital; 4University of Rochester Medicine

Type III sacrococcygeal teratomas (SCT) are most often approached through a combined open-abdominal and perineal approach. We describe the removal of a cystic type III SCT through a laparoscopic abdominal approach and a midsagittal gluteal incision. The patient is a full-term infant with an antenatal diagnosis of SCT. On day-of-life 4, he underwent SCT excision. Laparoscopic access was gained through an open approach. The cyst was drained and the cystotomy was closed. The middle sacral artery was secured. The cyst was circumferentially dissected toward the perineum. The bladder was suspended with a transabdominal suture for better visualization. The perineal approach was a sagittal incision through the natal cleft. The patient had an uncomplicated course and was discharged on post-operative-day four. Follow up MRI within a year showed no recurrence. At two years, he has normal bladder and bowel function. Laparoscopic approach is feasible and effective for a cystic SCT resection.

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