V05-04 RENAL HYDATID: LAPAROSCOPIC PERICYSTECTOMY AND OMENTOPLASTY USING PALANIVELU HYDATID SYSTEM

Abstract

You have accessJournal of UrologyUpper-Tract Reconstruction (V05)1 Apr 2020V05-04 RENAL HYDATID: LAPAROSCOPIC PERICYSTECTOMY AND OMENTOPLASTY USING PALANIVELU HYDATID SYSTEM Prashant mulawkar*, Abhishek Bhagwat, Parag Tapre, Giridhar Panpaliya, Amol Khandelwal, and Sumeet Agrawal Prashant mulawkar*Prashant mulawkar* More articles by this author , Abhishek BhagwatAbhishek Bhagwat More articles by this author , Parag TapreParag Tapre More articles by this author , Giridhar PanpaliyaGiridhar Panpaliya More articles by this author , Amol KhandelwalAmol Khandelwal More articles by this author , and Sumeet AgrawalSumeet Agrawal More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000874.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Hydatid disease is endemic in Mediterranean countries and Indian subcontinent. But renal Hydatid is a rare disease. We present a case of primary left renal hydatid cyst managed laparoscopically. METHODS: Forty one year male patient presented with left flank pain and passage of grape like material in urine. His left kidney was palpable. Computed tomography showed a 17x12 cm cystic lesion at the lower pole of left kidney. Left kidney showed delayed excretion of the contrast, moderate hydronephrosis. On delayed CT spots, there was pooling of excreted contrast and multiple daughter cysts which were seen as filling defects. He was put on albendazole and scheduled for laparoscopic surgery after two weeks. The challenges in laparoscopic hydatid surgery are avoidance of spillage and minimizing the incision for specimen retrieval. Both these issues are taken care of by Palanivelu hydatid system (PHS). The PHS consists of a 12 mm laparoscopy trocar and canula. The trocar is fenestrated at tip and hollow throughout. Each facet of the pyramidal tip is fenestrated to allow suction of the hydatid fluid leaking on the insertion. The shaft of the trocar also bears two fenestrations. There are two side channels, smaller for irrigation and the larger for suction. Preliminary left ureteric catheterization was done. Three laparoscopic ports were used for the access to the peritoneal cavity. The cyst was isolated with gauze soaked in scolicidal 1.6% NaCl. The renal hydatid cyst was approached with PHS through a separate port. A separate camera, telescope, light source and monitor was used for the PHS system and primary laparoscopy. All daughter cysts were sucked out through PHS. The cavity was irrigated thrice with scolicidal NaCl. Pericyst was excised partly. Communication with the collecting system was sutured. Omentoplasty was done. Drain was kept in the cavity. RESULTS: The lap operating time was 97 minutes. Blood loss was less than 100 ml. Total 2 liters of hydatid material was removed. Patient was orally allowed on Day 2 and discharged on Day 5. CONCLUSIONS: We demonstrate laparoscopic management of renal hydatid cyst without spillage using the PHS System. Source of Funding: Nil © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e471-e471 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Prashant mulawkar* More articles by this author Abhishek Bhagwat More articles by this author Parag Tapre More articles by this author Giridhar Panpaliya More articles by this author Amol Khandelwal More articles by this author Sumeet Agrawal More articles by this author Expand All Advertisement PDF downloadLoading ...