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Excision of a frontal subcutaneous angioma by videosurgery

E. Guye, M. Lopez, MB Hardy, F. Lardellier, F. Varlet

Department of Pediatric Surgery, CHU Saint-Etienne, France



Aim: To present the surgical technique and the results of the excision of a frontal subcutaneous lesion by video surgery.

Material and methods: Appearance of a left frontal tumefaction in a 4-month-old girl, increasing in volume gradually. At 8 months, it measured 2 cm in diameter; it was soft and mobile, not attached to the skin or the underlying structures. Ultrasonography revealed a hyperechoic mass without communication with the profound tissues, compatible with a lipoma. The parents wanted the excision of this deforming lesion of the face and we proposed to perform it by videosurgery with their agreement.

Results: The intervention was carried out at the age of 9 months; 3 trocars were placed in the left frontal scalp, central optic trocar of 5 mm and one of 3 mm on each side for the instruments. The subcutaneous insufflation pressure was 8 mm Hg and cleavage was very easy. The lesion was well limited and its dissection was carried out using bipolar electrosurgical instrument. The lesion was exteriorized by the 5 mm trocar incision, slightly increased. The postoperative evolution was simple and the result was excellent, with postoperative scars hidden in the hair. The histopathologic examination revealed a juvenile capillary angioma composed of multiple small nodules.

Discussion: This videosurgical approach was already reported for the excision of lipoma, osteoma and eyebrow cysts. It is the first report for an angiomatous lesion.

Conclusion: We report the first excision of a subcutaneous angioma by videosurgery, a simple procedure avoiding scars of the face. This technique should extend to subcutaneous lesions of any type and any localization, by choosing sites not very visible for the introduction of the trocars.


Key words: frontal subcutaneous angioma, laparoscopic excision