Laparoscopic transabdominal excision of presacral cyst shows no recurrence at 3 months in case reportLaparoscopic Surgery for Presacral Cysts Shows Early Promise in One Case

Frontiers in Medicine Published June 4, 2026 DOI ↗ Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

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Key Takeaway

Consider laparoscopic transabdominal excision for presacral cysts in selected patients, but long-term data are lacking.

This is a case report combined with a narrative mini-review, focusing on the feasibility and safety of a laparoscopic transabdominal approach for radical excision of presacral cysts. The patient was a 39-year-old woman with a history of constipation and prior cesarean section. The procedure was performed by experienced surgeons, and at 3-month follow-up, the patient had no recurrence and no complications, recovering well.

The authors note that while the short-term results are encouraging, long-term follow-up is required to confirm recurrence outcomes. The mini-review context suggests that this approach may be feasible in selected patients, but the evidence is limited to a single case.

Limitations include the lack of long-term data and the inherent constraints of a single case report. The practice relevance is that the laparoscopic transabdominal approach appears feasible for radical excision of low-lying presacral cysts in selected patients when performed by experienced surgeons, but feasibility and safety remain to be fully evaluated.

This case report and narrative mini-review describes the treatment of a 39-year-old female patient with a presacral cyst and a history of constipation. The patient had no other significant medical history and had previously undergone a cesarean section. She underwent a laparoscopic transabdominal approach for radical excision of the cyst. The primary goal was to assess the feasibility and safety of this surgical method.

At a three-month follow-up, the patient recovered well. There were no complications reported during the procedure or recovery period. Additionally, there was no recurrence of the cyst at this time point. The study notes that the surgery was performed by experienced surgeons, which is a key factor in the reported success.

Readers should understand that this evidence comes from a single patient case. Long-term follow-up is required to confirm whether the cyst might return later. While the laparoscopic transabdominal approach appears feasible for low-lying presacral cysts in selected patients, the feasibility and safety remain to be fully evaluated. This report does not change current practice but offers a preliminary look at this specific surgical technique.

What this means for you:

One patient recovered well after laparoscopic cyst removal with no complications at three months, but long-term data is needed.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

BackgroundPresacral cysts are clinically rare, deeply located, and pose diagnostic challenges prior to surgery. Complete surgical resection is the primary treatment. Laparoscopic techniques offer minimally invasive advantages; however, the feasibility and safety of the transabdominal approach for low-lying cysts remain to be fully evaluated. Through this case report and narrative mini−review, this study aims to assess the technical characteristics and value of this approach.Clinical presentationA 39-year-old female patient, with a history of constipation, no other significant medical history, and a prior cesarean section, presented due to a presacral cystic mass discovered during a routine gynecological ultrasound. She reported no specific discomfort such as abdominal distension or pain. Contrast-enhanced abdominopelvic CT revealed a cystic, low-density lesion in the presacral region (approximately 8.3 cm × 6.2 cm, with a pre-contrast CT value of about 28 HU), showing no significant enhancement. Pelvic MRI demonstrated that the cystic lesion exhibited slightly low signal on T1-weighted images (T1WI), slightly high signal on T2-weighted images (T2WI), markedly high signal on diffusion-weighted imaging (DWI), and low signal on apparent diffusion coefficient (ADC) map. The superior pole of the cyst was at the level of the coccyx. Digital rectal examination revealed a soft mass posterolateral to the rectum. After multidisciplinary discussion and thorough communication with the patient, a laparoscopic exploration was decided upon. Intraoperatively, a well-defined cystic tumor was visualized posterior to the rectum and was completely resected. Postoperative pathological diagnosis confirmed a (presacral) epidermoid cyst. At the 3-month follow-up, the patient recovered well with no recurrence or complications.ConclusionThe laparoscopic transabdominal approach appears feasible for radical excision of low−lying presacral cysts in selected patients when performed by experienced surgeons. Long−term follow−up is required to confirm recurrence outcomes.

Laparoscopic transabdominal excision of presacral cyst shows no recurrence at 3 months in case reportLaparoscopic Surgery for Presacral Cysts Shows Early Promise in One Case

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