Use of microcatheter for intraabdominal survey.
BACKGROUND
Laparoscopy is the most common procedure for minimally invasive intraabdominal surveys. Patients with pulmonary hypertension (PHTN) may need an alternate approach because the systemic absorption of carbon dioxide may lead to hypercapnia, acidemia, and increases in systemic and pulmonary pressures. We report a case of intraabdominal survey using a microcatheter trocar (Check-Flo Introducer) in a patient with a large adnexal mass and PHTN.


METHODS
An adolescent girl with severe PHTN and multiple cardiac anomalies presented with oligomenorrhea. During the course of workup, an ultrasound revealed an 8-cm simple cyst in the right adnexa, which required removal. The decision was made to proceed with cystectomy. The patient was not a candidate for laparoscopy, and an alternative method was used. The Check-Flo Introducer, a microcatheter trocar; crystalloid fluid infusion; and a 3-mm laparoscopic camera were used to survey the abdominal cavity, revealing a 10-cm simple paratubal cyst that could be safely drained and removed via a minilaparotomy incision.


CONCLUSIONS
The microcatheter trocar is a useful and novel alternative in patients who cannot tolerate increases in intraabdominal pressure.
Section of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA. sokkary@bcm.tmc.edu
Nancy
N
Sokkary
Catalina
C
Granada
Thomas
T
Cunningham
Jennifer E
JE
Dietrich
D000293:Adolescent; D057785:Catheters; D003560:Cysts / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D007813:Laparotomy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods