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Laparoscopic marsupialization of the difficult lymphocele using internalized peritoneal dialysis catheter
1Section of Laparoscopic and Minimally Invasive Surgery, Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Purpose:
Definitive treatment of the recurrent or anatomically difficult lymphocele without a common wall between the lymphocele and peritoneal cavities requires open surgery. We present a novel technique of laparoscopic marsupialization of such lymphoceles with placement of a cable of 2 internalized peritoneal dialysis catheters for maintaining permanent lymphoperitoneal drainage.
Materials And Methods:
Two patients with a symptomatic, post-renal transplant pelvic lymphocele underwent the procedure. Laparoscopic marsupialization was performed with ultrasound guidance and in each case a cable of 2 internalized peritoneal dialysis catheters was anchored through the limited peritoneal window to maintain lymphoperitoneal drainage.
Results:
Both procedures were successful. During a followup of 20 and 21 months, respectively, no recurrence or infectious complications were noted in these immunocompromised patients.
Conclusions:
Laparoscopic marsupialization with internalization of peritoneal dialysis catheters is a feasible, alternative measure available for select cases with a difficult or recurrent lymphocele.