Endoscopic Unroofing of a Postraumatic Splenic Cyst Through a Transumbilical Single Port Access

Laparoscopic approach is the gold standard for treatment of symptomatic splenic cysts and unroofing is the best accepted procedure . There is currently a trend to reduce the invasiveness of minimally invasive procedures. Single port access is alternative to conventional laparoscopy but no reports have yet been published in relation to splenic cysts. AIM: To describe the SAP technique for unroofing a symptomatic posttraumatic splenic cyst. MAT. & METH.. A 26-yr female diagnosed of a lower pole splenic cyst (12 cm), month after a motorbike accident. Surgical technique: It was divided into 4 steps: 1.- Patient position: standard right decubitus with the table flexed at the flank, 2. – Transumbilical trocar insertion: A 15 mm periumbilical incision and a Triport device (ACS, Ireland) was inserted. A 10 mm HD flexible tip scope and 2 5 mm instruments were used. 3.- Splenic cyst unroofing. The cyst was incised and the content fluid aspired The 80 percent of the lower part of the cyst was excised using the ultracision. Dissection was facilitated with a curved instrument and the use of a flexible tip 10 mm and a rigid 5 mm scope. 4.- Cyst wall extraction. Once the cyst wall was excised, the 10 mm scope was replaced by a 5 mm scope, and an endobag was inserted in the 10 mm orifice. The fragments of the cyst wall were retrieved trough the bag. The mean op time was 120’ and blood loss was minimal. RESULTS: The postoperative course was uneventful. The patient had minimal postoperative pain and scarring, and was discharged on the second postoperative day. CONCLUSIONS: SAP access can be safely used for operative visualization, and cyst unroofing, reducing parietal wall trauma to a minimum. The clinical, esthetic and functional advantages require further analysis.

Session: Video Channel

Program Number: V086

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