Splenic pedicle control during laparoscopic de-capsulation of a giant splenic cyst

Splenic cysts are a rare entity in the Western population and are either true cysts (primary, 25%) or pseudocysts (secondary, 75%) complicating trauma, haemorrhage or infarction. Congenital or simple splenic cysts are the commonest primary cysts and surgery is recommended for cysts larger than 5 cm as these are prone to infection, bleeding or rupture and for symptomatic or complicated cysts. Splenic preservation techniques using the laparoscopic approach are the most prevalent. We present a case of a giant painful simple splenic cyst treated with laparoscopic de-capsulation with application of a new technique for achieving vascular control, whereby control of the splenic pedicle was achieved using a Nylon tape. This approach was safe and well tolerated with a total splenic ischaemia time of 30 min and a successful result. The patient was discharged with no antecedent complications and no recurrence of the cyst at 6 months follow up ultrasound scan.