Laparoscopic hand-assisted splenectomy for hydatid cyst

Hydatid cyst of the spleen is a rare location even in endemic areas. From classical splenectomy, surgical treatment has evolved to more conservative and even minimal invasive techniques. The authors report a 44 year old male with a palpable but asymptomatic mass in the left hypochondrium. Ultrasonography and computed tomography confirmed a large round unilocular cystic imagine of 12.5 cm in diameter with a thin regular wall. A total splenectomy was performed laparoscopic, the dissection being directed upward from the lower peritoneal attachments continuing with delivery of the anterior aspect of the hilum and splenorenal ligament, interception of main splenic vessels and finally detachment of the superior pole of the spleen where the cyst is adherent to the diaphragm muscle. The all delivered spleen was partial evacuated of hydatid content and the extraction was done via a mini-laparatomy with a digital lever manoeuvre. The 200 minutes operation has an uneventful postoperative course and the patient is still well 12 and 24 months after surgery without recurrence. The laparoscopic approach of hydatid cyst of the spleen constituted a challenging therapeutic perspective in selected cases and a good expertise of the surgeons.