V3-10: LESS Gonadectomy for Androgen Insensitivity Syndrome (AIS)

Video

Introductions and Objectives
The pathogenetical basis of testicular feminization is androgen insensitivity. Patients with complete androgen insensitivity syndrome are raised as females because they have female external genitalia. It is well accepted that laparoscopy access is primarily indicated in intersex patients and also in the management of impalpable gonads in normal population. The aim of this video is to demonstrate the use of laparoendoscopic single site surgery in order to manage androgen insensitivity syndrome.

Methods
A 15-year old woman was referred to our service with primary amenorrhea presenting normal external female genitalia, testosterone levels of 557ng/dl and 46-XY karyotype. MRI showed bilateral gonads in the pelvic cavity.

Results
A SILS (Covidien) single port device was introduced through the umbilical scar. Operative time was 18 minutes, blood loss 20ml, and the patient was discharged after 12 hours. The pathological analysis revealed the presence of seminiferous tubules.

Conclusions
Conclusively, the laparoendoscopic single site surgery in the treatment of androgen insensitivity syndrome is a feasible and safe approach, and should be considered as an excellent minimally invasive option, minimizing surgery impact.

Funding: none