Underutilization of Laparoscopy for Ovarian Surgeries in the Pediatric Population: A Nationwide Analysis


      • Oophorectomy and ovarian detorsion are common operations performed in the female pediatric population. Few studies have directly compared outcomes after laparoscopic and open approaches in the pediatric population.
      • Despite fewer overall complications and readmissions, decreased cost, and shorter length of stay, laparoscopic approaches are underutilized for pediatric ovarian procedures.



      Oophorectomy and ovarian detorsion are some of the most frequent operations performed in the female pediatric population. Despite the advent of laparoscopy, many surgeons continue to utilize open surgical approaches in these patients. This study sought to compare nationwide trends and postoperative outcomes in laparoscopic and open ovarian operations in the pediatric population.


      Females less than 21 years old who underwent ovarian operations (oophorectomy, detorsion, and/or drainage) from 2016-2017 were identified from the Nationwide Readmissions Database. Patients were stratified by surgical approach (laparoscopic or open). Hospital characteristics and outcomes were compared using standard statistical tests.


      There were 13,202 females (age 17 [14-20] years) underwent open (59%) or laparoscopic (41%) ovarian operations. The most common indications for surgery were ovarian mass (48%), cyst (36%), and/or torsion (19%) for which oophorectomy (88%), detorsion (26%), and drainage (13%) were performed most frequently. The open approach was utilized more frequently for oophorectomy (95% vs. 77% laparoscopic) and detorsion (33% vs. 16% laparoscopic), both p<0.001. A greater proportion of laparoscopic procedures were performed at large (67% vs. 61% open), teaching (82% vs. 76% open) hospitals in patients with private insurance (47% vs. 42% open), all p<0.001. Patients undergoing open procedures had significantly higher index length of stay (LOS) and rates of wound infections. Thirty-day and overall readmission rates, as well as overall readmission costs, were higher in patients who received open surgeries.


      Despite fewer overall complications, decreased cost, fewer readmissions, and shorter LOS, laparoscopic approaches are underutilized for pediatric ovarian procedures.

      Type of Study

      Retrospective Comparative.

      Level of Evidence

      Level III.


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