Transperitoneal guide-wire or drainage catheter placement for guidance of laparoscopic marsupialization of lymphocoeles post renal transplantation.
BACKGROUND
Lymphocoeles post renal transplantation can be difficult to see laparoscopically. The objective of this study was to report a new technique of catheter or guide-wire placement for the guidance of laparoscopic marsupialization of symptomatic post renal transplant lymphocoeles, refractory to conservative therapy.


METHODS
Conventional aseptic technique under local anaesthesia was used for guide-wire or catheter insertion, with the difference being the use of a transperitoneal approach. Computerized tomography (CT) or ultrasound (US) guidance was used. All lesions were confirmed to be sterile lymphocoeles beforehand by either needle aspiration or previous catheter drainage.


RESULTS
Four catheters and one guide-wire were placed pre-operatively without complication. All cases underwent satisfactory laparoscopic marsupialization. No immediate complications were noted in any patient. The drainage catheters were inserted between 5 and 19 days before laparoscopic marsupialization, and guide-wire inserted immediately before. All patients proceeded to laparoscopic marsupialization.


CONCLUSIONS
This technique offers precise guidance on laparoscopic surgery, is relatively simple to perform and no complications were experienced in this study. Its use is limited to sterile and benign lesions due to the risks of peritoneal seeding, making recurrent post-operative lymphocoeles ideally suited for this application.
Tie
M L
ML
Department of Radiology, North Western Adelaide Health Service, The Queen Elizabeth Hospital Campus, Woodville, Adelaide, South Australia 5011, Australia.
Rao
M M
MM
Russell
C
C
Burapa
K
K
D000328:Adult; D002404:Catheterization; D004322:Drainage / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy; D008210:Lymphocele / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019738:Surgically-Created Structures