Résumé
In 1986, Tan and Bianchi reported that the umbilical incision could be used for pyloromyotomy in infantile hypertrophic pyloric stenosis. Since then, many pediatric surgeons have used this approach for a number of other procedures. This work is an attempt to ascertain the feasibility of trans-umbilical incision in the management of neonatal ovarian cysts. From January 2008 to January 2011, 5 female newborns with ovarian cysts were treated via the trans-umbilical route. Indications for surgery were symptomatic simple cyst, cysts more than 5 cm. in diameter and complex cyst diagnosed by ultrasound. All patients were treated with a semicircular infra-umbilical incision. The wall of the cyst was grasped by forceps or sucked by a suction tube then the content was aspirated and the partially collapsed cyst was then delivered through the incision easily. Cystectomy with ovarian tissue sparing was performed outside the abdominal wall in all cases. All the patients were followed for at least 6 month post-operatively. The cysts were simple in 4 cases, and complex in one case. The average size was 9.7 cm. [ranged 7.2-12.5 cm.] for the simple cysts and 6.6 cm. for the complex cyst. The average age at operation was 13 days [ranged 2-25 days]. The mean operating time was 25.4 minutes [ranged 30 - 45 minutes]. All patients were discharged 24 hours after operation with uneventful post operative course. The scars were hardly detectable about 2 weeks later. All the patients were followed for at least 6 month post-operatively without complications. My experience has shown that the umbilical incision is an excellent, safe, and versatile alternative to laparoscopy or other open abdominal incisions for the treatment of neonatal ovarian cysts with even more better cosmetic results