Single-Sitting Laparoscopy for Large Pelvic Mass and Umbilical Hernia Through the Lee–Huang Portal

Abstract Background: Ovarian fibrothecoma is a benign ovarian tumor that is likely to be misdiagnosed as a malignancy, especially if the tumor is accompanied by ascites. Treatment for elderly patients seems challenging, because of the condition and other complications that interfere with good quality of life. Case: An 82-year-old Taiwanese woman with a solid ovarian mass, ascites, elevated CA-125, and an umbilical hernia is presented. This patient was referred for progressive abdominal distention without pain. She had noticed a significant weight loss within the previous year, despite her normal appetite. Her CA-125 level was 125 U/mL. Computed tomography revealed a right–sided solid ovarian mass that appeared to be malignant and that measured 12.4×11.4×6.3 cm. The mass was accompanied by ascites, and a small umbilical herniation. The left ovary was normal. The patient underwent single-sitting laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy and umbilical hernioplasty (Mayo ...