Laparoscopic excision of mesenteric cyst

Posted by Jafrul Hannan on Sun, Nov 1, 2009  
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A 2.5-year-old girl presented with gradual abdominal distention since 2 year of age, abdominal pain and failure to thrive. Bowel and bladder habits were normal. Abdomen was found hugely distended and a vague cystic mass could be felt which was mobile. Differential diagnoses were mesenteric cyst, ovarian cyst and hydronephrosis. Ultrasonogram revealed a huge mult-septated lesion in the abdomen with normal kidneys and pelvic organs suggestive of mesenteric cyst. Laparoscopy was planned. After introduction of telescope through supra-umbilical port the cyst was found. Aspiration of cyst content was done using a percutaneous needle to reduce the size. Then two more ports were placed, one medial to left anterior superior spine and another above the pubic crest on right. The sacs were then identified. Circumferential incision was given using mono and bipolar cautery on the cyst and most of the wall removed. The inner lining from the rest of the basal portion of cyst was separated and removed. Two other cysts were handled in the same manner. Peritoneal wash was given with normal saline. Ports were then closed keeping drain. Feeding was allowed after 6 hours and drain removed after 48 hours. Baby was discharged on 3rd post-operative day and doing well 1 month after operation. 

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