Laparoscopic removal of a gastric trichobezoar in a pediatric patient.

Trichobezoars from the ingestion of hair typically develop into a large, spherical foreign body within the stomach. Due to the frequently large size, endoscopic removal is usually not feasible beyond diagnosis. Likewise, the size often has forced surgeons to remove these trichobezoars via laparotomy. Laparoscopic removal of gastric trichobezoars has been reported, but the concern with this technique is that the complete removal of the large bezoar without spillage of hairs in the peritoneal cavity may be difficult. As such, most of the reports are laparoscopic assisted, but still utilize an extended incision to facilitate direct removal from the peritoneal cavity. In this case, we describe in this paper the complete laparoscopic removal of a giant trichobezoar in a 10-year-old child without spillage, using piecemeal removal through the umbilical incision without extending the incisions.