Introduction/Background The uptake of a minimally invasive approach in the management of gynaecological malignancies has increased over the years, because of advancement in skills, equipment, and the advantages of a swifter recovery, lower blood loss and reduction in the length of hospitalisation. However, this has been viewed with much hesitance in the realm of ovarian malignancies due to fear of spill and incomplete clearance of tumour, especially when the tumours are large.

Methodology We describe two cases in which the large pelvic masses (both about 12 cm in size) were handled in an oncologically sound manner, allowing for accurate intra abdominal assessment of disease, and removal of the ovarian mass without surgical spill. The first is that of an ovarian immature teratoma with gliomatosis peritonei in a 6 year old girl, the second is that of a 35 year old lady with a mucinous ovarian carcinoma.

Results In the case of the 6 year old, a computed tomography scan showed a 12 cm heterogenous suspicious looking ovarian mass with significantly elevated alpha-feto-protein levels, with no evidence of distal or nodal metastases. A laparoscopic approach was undertaken to remove this mass with the steps outlined below. 1. Supraumbilical camera port placement and intra abdominal survey 2. Peritoneal washings 3. Tilting patient to expose the gonadal vessels; isolating the ureter before performing a unilateral salpingo oophorectomy (USO) 4. Putting the entire USO specimen into a 6 litre retrieval bag and removal via the suprapubic port with manual morcellation 5. Omental biopsy, examination of bowel and mesentery, digital palpation of the retroperitoneal lymph nodes performed 6. Excision of pouch of Douglas (POD) lesions performed. The second case was approached in a similar manner, excluding the final step.

Conclusion In carefully selected cases of ovarian malignancy, a minimally invasive approach can be undertaken safely.