Laparoscopic excision of a single hepatic hydatid cyst.

Many reports have recently shown the feasibility of treating simple cysts, polycystic disease of the liver and biliary cysts by laparoscopy. Groups having experience in this kind of surgery stressed the contraindication to manage hydatid cysts of the liver laparoscopically. This reflects the primary concern regarding the possibility of cyst content spillage. This presentation aims to demonstrate the feasibility and safety of laparoscopic treatment of special types of hepatic hydatid cysts. A 26-year-old female Yemeni patient presented with atypical gall bladder dyspepsia. Abdominal ultrasound only showed chronic calcular cholecystitis. The patient was scheduled for laparoscopic cholecystectomy on the 18th of August 1992. On exploration a globular cyst about 12 cm hanging with a stalk from the under surface of the right lobe of the liver was noticed. The gall bladder was used to elevate the liver. Dissection of the mass from the surrounding structures was achieved. Puncture and suction of the germinal and laminated layers were done. The connecting stalk was doubly ligated with endoloops and cut in between. The patient made an uneventful recovery and was discharged 48 hours later. Hydatid cysts of the liver are dangerous to handle by laparoscopy. However whenever a case is met with where excision can be done, this could be achieved laparoscopically especially in pedunculated cysts. A device of 2 coaxial suckers is presented to procure laparoscopic management of hydatid cysts enough safety against "spillage of contents" as in open surgery.