Laparoscopic Removal of a Large Gastric Trichobezoar in a 4-Year-Old Girl

Background: Standard treatment of large gastric bezoars not amenable to medical or endoscopic management is surgical removal. The optimal operative approach, laparotomy versus laparoscopy, is a contested subject. Though laparoscopic removal has been described, it remains a relatively new technique for surgical management with outcome literature limited to case reports. In addition, currently described laparoscopic techniques often involve limited midline laparotomy incisions or >3 cm extensions of port sites. Methods: The following describes the case of a 4-yearold girl with a large gastric trichobezoar. Results: The gastric trichobezoar was successfully removed through a 12-mm left lower quadrant trocar incision cosmetically hidden within a skin crease. Conclusion: This case, along with accumulating literature, supports the use of laparoscopy to treat large gastric bezoars. © 2009 by JSLS.