{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:50:22Z","timestamp":1792169422894,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":168,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["ROR identifier:00x0ma614"],"award-info":[{"award-number":["ROR identifier:00x0ma614"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bilateral ovarian tumors in pediatric patients present a surgical challenge requiring complete tumor removal while preserving sufficient ovarian tissue for endocrine function and future fertility. In bilateral disease, preservation is often feasible only on the ovary that retains salvageable parenchyma. Exoscope systems provide high\u2010definition magnified visualization of the operative field. To our knowledge, this is one of the first reports of exoscope\u2010assisted ovarian\u2010sparing surgery in pediatric patients. This study describes the technical feasibility of the technique and the completeness of tumor removal with preservation of ovarian parenchyma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case series of four patients with bilateral ovarian tumors who underwent exoscope\u2010assisted ovarian\u2010sparing surgery between 2020 and 2024 at a Brazilian pediatric cancer center. Eligible patients had imaging consistent with benign lesions and normal serum tumor markers. Surgical technique combined exoscopic magnification with intraoperative ultrasonography in open procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients had mature teratomas confirmed on final pathology. No intraoperative capsular ruptures occurred across the four preservation procedures. Mean follow\u2010up was 31.0\u2009months (range 20\u201339). Two patients maintained regular spontaneous menses without hormonal supplementation. One patient developed clinical hypogonadism 8\u2009months after surgery and received hormone replacement therapy, after which regular cycles resumed. One patient was not assessable for spontaneous menstrual recovery because continuous combined hormonal contraception was started after surgery at her request. No tumor recurrence occurred during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exoscope\u2010assisted ovarian\u2010sparing surgery was technically feasible for the contralateral or remaining ovary in adolescents with bilateral mature teratomas. Spontaneous menstrual function was preserved in two of four patients, one required hormone replacement therapy, and one was not assessable. Controlled studies that include objective ovarian reserve markers and extended follow\u2010up are required before the added value of the exoscope can be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70331","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:10:31Z","timestamp":1781827831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exoscope\u2010Assisted Ovarian\u2010Sparing Resection of Contralateral Mature Teratomas in Bilateral Pediatric Ovarian Disease: A Case Series"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9812-6282","authenticated-orcid":false,"given":"Wilson E.","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Children's Cancer Hospital, Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"},{"name":"\u201cInnovation in Healthcare\u201d Post\u2010Graduation Program, Hospital de Amor\/Faculdade de Ci\u00eancias da Sa\u00fade \u201cDr Paulo Prata\u201d (FACISB)  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Rezende","family":"Rosa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Children's Cancer Hospital, Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"},{"name":"\u201cInnovation in Healthcare\u201d Post\u2010Graduation Program, Hospital de Amor\/Faculdade de Ci\u00eancias da Sa\u00fade \u201cDr Paulo Prata\u201d (FACISB)  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele Eiras","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Children's Cancer Hospital, Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"da Silveira Orsi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Children's Cancer Hospital, Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia Semissato","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Children's Cancer Hospital, Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"},{"name":"\u201cInnovation in Healthcare\u201d Post\u2010Graduation Program, Hospital de Amor\/Faculdade de Ci\u00eancias da Sa\u00fade \u201cDr Paulo Prata\u201d (FACISB)  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Laura Balduino","family":"do Nascimento","sequence":"additional","affiliation":[{"name":"\u201cInnovation in Healthcare\u201d Post\u2010Graduation Program, Hospital de Amor\/Faculdade de Ci\u00eancias da Sa\u00fade \u201cDr Paulo Prata\u201d (FACISB)  Barretos S\u00e3o Paulo Brazil"},{"name":"Barretos Medical School, Faculdade de Ci\u00eancias da Sa\u00fade \u201cDr Paulo Prata\u201d (FACISB)  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Fernando","family":"Lopes","sequence":"additional","affiliation":[{"name":"Scientific Director, Children's Cancer Hospital Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Chaves","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Children's Cancer Hospital, Barretos Cancer Hospital  Barretos S\u00e3o Paulo Brazil"},{"name":"\u201cInnovation in Healthcare\u201d Post\u2010Graduation Program, Hospital de Amor\/Faculdade de Ci\u00eancias da Sa\u00fade \u201cDr Paulo Prata\u201d (FACISB)  Barretos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"issue":"12","key":"e_1_2_11_2_1","first-page":"e29421","article-title":"Lessons From a Large Nationwide Cohort of 350 Children With Ovarian Mature Teratoma: A Study in Favor of Ovarian\u2010Sparing Surgery","volume":"68","author":"Delehaye F.","year":"2021","journal-title":"Pediatric Blood & Cancer"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-021-04950-x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.02.027"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2019.0515"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1553350620965344"},{"key":"e_1_2_11_7_1","volume-title":"Protocolo TCG\u2010GALOP\u20102017: tumores de c\u00e9lulas germinativas da inf\u00e2ncia e adolesc\u00eancia","author":"Lopes L. F.","year":"2018"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.944662"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1716877"},{"issue":"1","key":"e_1_2_11_10_1","first-page":"24","article-title":"Recurrence and Metachronous Disease in Children With Benign Ovarian Tumors: A Systematic Review of the Literature","volume":"32","author":"Braungart S.","year":"2022","journal-title":"European Journal of Pediatric Surgery"},{"issue":"12","key":"e_1_2_11_11_1","first-page":"2473","article-title":"Laparoscopic Ovarian\u2010Sparing Surgery for the Management of Benign Ovarian Lesions in Pediatric Patients: A Retrospective Analysis","volume":"58","author":"Piotrowska\u2010Gall A.","year":"2023","journal-title":"Journal of Pediatric Surgery"}],"container-title":["Asian Journal of Endoscopic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70331","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ases.70331","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ases.70331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:06:44Z","timestamp":1792166804000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ases.70331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ases.70331"],"URL":"https:\/\/doi.org\/10.1111\/ases.70331","archive":["Portico"],"relation":{},"ISSN":["1758-5902","1758-5910"],"issn-type":[{"value":"1758-5902","type":"print"},{"value":"1758-5910","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70331"}}