1. www. metinertem.com [email_address] Laparoscopic treatment of the hydatid cysts Metin Ertem, MD, FACS Professor of General Surgery Istanbul University Cerrahpasa School of Medicine
2. First trokar is inserted through umbilicus and abdominal cavity is explorated . Here is seen a large cysts flooding from liver.
3. Two suction instruments for security
4. To prevent any spillage of the cystic material, gauzes are placed around the cyst and then they suck the scolecidal fluid.
5. Aspiration needle
6. Puncture of the cyst with needle
8. Germinal membrane
9. If the cyst position is suitable, germinal membrane can be placed into the endobag
10. Germinative membrane are placed into the endo-bag.
11. Endo-bag is taken out from the abdominal cavity through the umbilical trocar
12. The cavity is irrigated and aspirated with povidine-iodine solution
13. Un-roofing or partial cystectomy is performed
14. Partial cystectomy is performed and the drain is placed. If the cavity is big Omentoplasty can be done.
15. CT image before operation
16. CT image after operation
17. If the cyst is in a difficult position , wide suction tube is inserted in the cyst cavity. So the germinal membrane is aspirated rapidly, safely and in one lot. The 15 mm diameter suction tube is used through the 18 mm trocar.