Single incision multi-trocar hepatic cyst excision with partial splenectomy.

Area of Science:

• Minimally Invasive Surgery
• Hepatobiliary Surgery
• Transplant Surgery

Background:

• Hydatid cysts in multiple abdominal organs present significant laparoscopic challenges.
• Standard laparoscopic approaches require complex port placement and patient positioning for multi-organ involvement.
• Single-incision multi-trocar techniques offer advantages for accessing different abdominal quadrants from a single incision.

Purpose of the Study:

• To report the first case of laparo-endoscopic single-site hepatic cyst excision with partial splenectomy for hydatid cysts in the liver and spleen.
• To evaluate the feasibility and safety of a single-incision multi-trocar technique for combined procedures in different abdominal quadrants.

Main Methods:

• A 64-year-old female with hydatid cysts in the liver (segment VIII) and spleen underwent a single-incision laparoscopic procedure.
• A transverse 3 cm incision was made above the umbilicus, with two 10mm and one 5mm ports inserted.
• Conventional laparoscopic instruments were utilized for the combined hepatic cyst excision and partial splenectomy.

Main Results:

• The procedure was successfully completed in 160 minutes without intra-operative complications.
• The patient experienced no post-operative complications and was discharged on day 5.
• This technique allowed for effective management of hydatid cysts in two separate abdominal organs via a single incision.

Conclusions:

• Single-incision multi-trocar surgery provides cosmetic benefits over standard laparoscopy, especially for combined procedures.
• This rare combination procedure using a single-incision approach warrants further investigation for potential benefits like reduced hospital stay and cost-effectiveness.