Giant Nonparasitic Splenic Cyst Managed by Minilaparoscopy
Gustavo Lopes de Carvalho, MD, PhD, Diego Laurentino Lima, MD, Frederico Wagner Silva, MD, Gustavo Henrique Belarmino de Go ́es
Department of General Surgery, University of Pernambuco (UPE), Faculty of Medical Sciences, Recife, Brazil (Dr. Carvalho, and Mr. GÓES) and Clinica Cirurgica Videolaparoscopica, Recife, Brazil (Dr. Carvalho).
State Servers Hospital, Recife, Brazil (Dr. Lima).
Minimally Invasive Surgery Program, Getulio Vargas Hospital, Recife, Brazil (Dr. Silva).
ABSTRACT
Introduction: Nonparasitic splenic cyst (NPSC) is a rare disease of the spleen and is categorized as a true or pseudocyst. Traditionally, the management of NPSC is partial or total splenectomy by laparotomy; however, minimally invasive surgery has shown efficacy in the treatment of this disease and is currently considered the gold standard treatment.
Case Description: This study reports an 11-year-old female patient who was diagnosed with a splenic cyst 10 cm in diameter. A sonographic scan showed a giant splenic cyst (10 8.8 7.6 cm). After diagnosis, the patient was completely asymptomatic and underwent periodic sonograms, which showed the lesion to be of constant size. This finding was confirmed by a computed tomographic scan of the abdomen. Then, the patient developed recurrent episodes of pain in the left upper quadrant. Three low-friction 3-mm minilaparoscopic trocars and an 11-mm port in the umbilical region for the insertion of the optics were used in this procedure. The cyst was punctured and its contents completely aspirated. It was then resected carefully by electrocautery in its margins, preserving as much splenic tissue as possible.
Conclusion: The minilaparoscopic approach is a safe and effective technique for this procedure.
Key Words: Minilaparoscopy, Splenic cyst.