Varun Jain, MD, Daniel H Rhee, MD, David Pearson, MD, James Madura, MD, Chee-Chee Stucky, MD. Mayo Clinic Hospital, Phoenix
Here we present an operative video for the case of a young adult male who presented with fairly rapid onset and worsening of his abdominal symptoms caused due to a giant mesenteric lymphangioma, managed safely via a laparoscopic approach. The video outlines, a step by step approach to proceed with careful dissection and complete surgical excision of the large cyst.
Background: Lymphangiomas are rare congenital lymphatic malformations, usually occurring in children, uncommon in adults. They usually involve the neck and axilla with abdominal lymphangiomas being rare (<5%). When they are abdominal, sites involved are retroperitoneum, mesentery of intra-abdominal viscera, omentum with varying frequencies. Etiology is unclear, usually considered congenital, but other causes may be- trauma, lymphatic obstruction, surgery, or other inflammatory process, radiation. Clinical presentation is usually subtle and non- specific but may cause obvious symptoms due to mass effect when large. They may even have more serious complications such as rupture, bleeding, infection, torsion or bowel obstruction. Imaging (US, CT) can suggest a diagnosis, but definitive diagnosis is after histo-pathological examination following complete surgical resection. Other treatment modalities such as percutaneous drainage, injection of sclerosant, marsupialization can be attempted for high risk surgical candidates. Recurrence averages around 6 % (ranging from 0-13%). Surgical technique may be either open or laparoscopic, with minimally invasive surgery offering an obvious cosmetic advantage with quicker recovery , however being technically challenging, especially for larger cysts.
Surgical technique may be either open or laparoscopic, with minimally invasive surgery offering an obvious cosmetic advantage with quicker recovery , however being technically challenging for larger cysts. Here we present a young male with fairly rapid onset and worsening of his symptoms caused due to a giant mesenteric lymphangioma, managed safely via a laparoscopic approach.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 92110
Program Number: V182
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop