title: Needlescopic decapsulation of a splenic epithelial cyst.
abstract: As technology advances, the techniques of laparoscopic surgery are being refined and their application is expanding to include many disease processes and organs. The new-generation laparoscopic instruments are becoming smaller (less than 5 mm). Expected advantages include improvements in cosmesis and patient satisfaction, and decreased postoperative analgesic requirements. Non-neoplastic cysts of the spleen are rare, and their management has evolved from total open splenectomy to laparoscopic cyst decapsulation. A 22-year-old woman with a symptomatic 10-cm epithelial cyst was treated by splenic decapsulation with needlescopic instruments (3 mm or smaller). Three trocars were used: one 12-mm umbilical and two 3-mm subcostal ports. The cyst was punctured by a Veress needle, and after drainage of straw-coloured fluid, circumferential decapsulation with 5-mm laparoscopic shears through the umbilical port site was done. The patient was discharged within 24 hours, having had a single intramuscular injection of meperidine and an excellent cosmetic result.
authors.affiliation: University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Ont.
authors.forename: P A
authors.initials: PA
authors.lastname: Seshadri
authors.forename: E C
authors.initials: EC
authors.lastname: Poulin
authors.forename: J
authors.initials: J
authors.lastname: Mamazza
authors.forename: C M
authors.initials: CM
authors.lastname: Schlachta
mesh_terms: D000328:Adult; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D009339:Needles; D011859:Radiography; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*