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RESECTION OF GIANT MESENTERIC AND OVARIAN CYSTS BY HYBRID MINIMALLY INVASIVE TECHNIQUE: A CASE REPORT

Diego L Lima, MD1, Gustavo L Carvalho, MD, phD2, Raimundo H Furtado, MD2, Gustavo H Belarmino de Goes, Medical Student2, Natália L Costa, Medical Student2. 1State Servers Hospital, 2University of Pernambuco

Case Report: a 51 years-old female patient with history of an increased mass and weight loss of 7 kilograms in 15 months, associated with vomiting and nausea for eight months. Abdominal ultrasound showed an irregular cyst, without solid projections and without signs of flow in Doppler, measuring 20 x 11 x 20 cm. Investigation continued with CT scan that showed a large homogeneous cystic lesion with no septum in the abdominopelvic region, possibly mesenteric, measuring 20.5 x 10.5 x 24 cm. A laparoscopic approach for resection of the cyst was then performed. The surgery was performed with a patient in the dorsal decubitus, using three trocars: one in the umbilical region (11-mm) for the camera, and where the pneumoperitoneum was created by the Hasson open technique under direct vision; and another two located in the epigastrium (5-mm) and in the right upper quadrant (3-mm). In addition to the mesenteric cyst, a simple cyst in the right ovary and a solid nodule with a lipomatous characteristic of approximately 3 cm in the abdominal cavity were visualized. Total resection of the mesenteric cyst with periprancreatic fibrous tissue was performed. The cyst was punctured and its contents fully aspirated. Resection of the right ovarian cyst was also performed. At the end of the procedure the mesenteric and ovarian cysts, the nodule, part of the omentum, and the peripancreatic tissue were removed through the 11- mm trocar at the umbilicus. Patient had no further complications, being discharged four days after the procedure. Histopathologic result showed a serous cyst in the right ovary, serous cyst in peripancreatic mesentery with chronic inflammatory process and signs of calcification; no signs of malignancy were observed in any specimen.

Conclusion: The Hybrid Laparoscopic technique was safe and effective for this procedure. The known advantages of the minimally invasive approach such as less trauma, greater dexterity, higher precision, lower postoperative pain, and shorter hospitalization time were confirmed.
 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86711

Program Number: P144

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

44

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