WOFAPS 2025 8th World Congress of Pediatric Surgery

Paulina Vargova, Reyes Delgado Alvira, Paolo Bragagnini Rodriguez, Andrea Santino Tenorio, Alvaro Mayordomo Ruiz, Carolina Corona Bellostas

Hospital Universitario Miguel Servet

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Aim of the study

Gastric trichobezoar is a rare condition often requiring surgery when non-operative methods fail. Minimally invasive techniques are emerging as safe and effective alternatives to traditional laparotomy.

Case description

A 13-year-old girl was admitted with abdominal pain, vomiting, and a palpable mass in the upper abdomen. Ultrasound and CT scans revealed a giant gastric trichobezoar. Endoscopy confirmed a large trichobezoar occupying the entire stomach and obstructing its contents.

A single port transumbilical laparoscopic approach was performed using a homemade glove port system with a surgical glove and two ports inserted into the glove fingers. The procedure included gastric opening, morcellation, and trichobezoar extraction using an endobag.

While the technique offers advantages such as a minimally invasive approach and improved cosmetic outcomes, the prolonged time required for morcellation was a limitation. Additionally, there is a minimal but potential risk of abdominal contamination during manipulation and extraction, which could complicate the postoperative course.

Despite an initial paralytic ileus, the patient progressed favorably, achieved complete oral tolerance by the seventh postoperative day, and was discharged in good condition.

Conclusions

Single-port laparoscopic surgery is a safe and effective technique for trichobezoar extraction, offering rapid recovery and significant cosmetic benefits. However, the morcellation time and potential risk of abdominal contamination should be considered during surgical planning.