Figure 2: Through a minimal incision, the cyst was extracted while aspirating the contents using an aspirator.

Mentions: With the patient under general anesthesia, a nasogastric tube and a Foley's bladder catheter were inserted. The patient was placed in the supine position, and a laparoscope was inserted through a 10-mm trocar immediately below the umbilicus by an open method. The intra-abdominal pressure with carbon dioxide was maintained at 8 mm Hg. We examined the peritoneal cavity and diagnosed that the cystic lesions with torsion had no connection with the normal reproductive organs and was attached to the greater omentum with pedicle (Figure 1). An additional 10-mm skin incision was made over the cystic lesion. A soft-cup aspirator® set (Hakko Co., Tokyo, Japan) was inserted, and the cyst was pulled out while its contents were aspirated (Figure 2). We studied the aspirated fluid with cytologic and bacterial examinations. The cystic lesion was pulled up to the umbilical wound and completely resected with a pedicle. In the patient with a left ovarian cyst, a cystostomy and a closure were carried out simultaneously (Case 2).

Kuga T, Inoue T, Taniguchi S, Zempo N, Esato K - JSLS (2000 Jul-Sep)

Bottom Line: Oral intake was commenced on postoperative day 2 in both patients.The cosmetic results following LAS were excellent.We conclude that LAS is suitable for the management of omental cystic lesions with torsion and ovarian cyst in nursing infants.An aspirator is useful in preventing spillage of cystic contents in patients with intra-abdominal cystic lesion.

Affiliation: First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.

Abstract: We report two cases of infants found to have congenital omental cystic lesion with torsion and ovarian cyst treated by laparoscopy-assisted surgery (LAS).A laparoscope was inserted by an open method. The intra-abdominal pressure was maintained at 8 mm Hg. We diagnosed the cystic lesions with torsion. At aspirator was used to aspirate the cystic content and remove the cyst.No intra- or postoperative complications were encountered. Oral intake was commenced on postoperative day 2 in both patients. The cosmetic results following LAS were excellent.We conclude that LAS is suitable for the management of omental cystic lesions with torsion and ovarian cyst in nursing infants. An aspirator is useful in preventing spillage of cystic contents in patients with intra-abdominal cystic lesion.