Laparoscopic marsupialization of the difficult lymphocele using internalized peritoneal dialysis catheter.
OBJECTIVE
Definitive treatment of the recurrent or anatomically difficult lymphocele without a common wall between the lymphocele and peritoneal cavities requires open surgery. We present a novel technique of laparoscopic marsupialization of such lymphoceles with placement of a cable of 2 internalized peritoneal dialysis catheters for maintaining permanent lymphoperitoneal drainage.


METHODS
Two patients with a symptomatic, post-renal transplant pelvic lymphocele underwent the procedure. Laparoscopic marsupialization was performed with ultrasound guidance and in each case a cable of 2 internalized peritoneal dialysis catheters was anchored through the limited peritoneal window to maintain lymphoperitoneal drainage.


RESULTS
Both procedures were successful. During a followup of 20 and 21 months, respectively, no recurrence or infectious complications were noted in these immunocompromised patients.


CONCLUSIONS
Laparoscopic marsupialization with internalization of peritoneal dialysis catheters is a feasible, alternative measure available for select cases with a difficult or recurrent lymphocele.
Matin
S F
SF
Section of Laparoscopic and Minimally Invasive Surgery, Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Gill
I S
IS
D002404:Catheterization; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008210:Lymphocele / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000295:instrumentation