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Laparoscopic resection of a appendiceal mucocele
Young-Tae Ju1, Soon-Tae Park, Woo-Song Ha
1Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Abstract:
Laparoscopic resection of appendiceal mucoceles has recently been described, but the safety and efficacy are controversial. We present two cases of laparoscopic mucocelectomies involving 14 and 15 cm cystic masses originating from the appendix. The laparoscopic mucocelectomies were performed using four ports. From the beginning of the procedure, a laparoscopic bag was used to safely contain the mucocele, prevent rupture of the mucocele, and retract the mucocele. An endoscopic stapling device was used to transect the base of the cecum. Minimal handling was achieved by gravity and with the use of laparoscopic instruments. Laparoscopic appendectomies are widely performed for acute appendicitis, but laparoscopic resection is not routinely performed for an appendiceal mucocele because of the risk of perforation and subsequent pseudomyxoma peritonei. We report two cases of laparoscopic appendiceal mucocelectomies, which were performed safely with laparoscopic instruments and minimal manipulation.
Insights
Laparoscopic mucocelectomy is a safe and effective technique for large appendiceal mucoceles. This minimally invasive approach prevents mucocele rupture and pseudomyxoma peritonei.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Appendiceal mucoceles are rare cystic neoplasms.
- Laparoscopic resection is controversial due to risks of perforation and pseudomyxoma peritonei.
Observation:
- Two cases of large (14-15 cm) appendiceal mucoceles treated laparoscopically.
- A laparoscopic bag was used to contain and retract the mucocele, preventing rupture.
- An endoscopic stapling device transected the cecal base; minimal manipulation was employed.
Findings:
- Successful laparoscopic mucocelectomy was achieved in both cases.
- The technique ensured containment and prevented spillage of mucinous material.
- Minimal handling and gravity aided in the procedure's efficiency.
Implications:
- Laparoscopic mucocelectomy can be a safe and effective alternative to open surgery.
- This approach minimizes the risk of pseudomyxoma peritonei.
- Further studies are warranted to establish laparoscopic mucocelectomy as a standard procedure.
