Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Asian J Endosc Surg. 2022 Jul;15(3):693-696. doi: 10.1111/ases.13052. Epub 2022 Mar 14.
In recent years, dome resection, which preserves the splenic immunological function, has been the primary technique used to treat splenic cysts. We herein report a surgical technique using a needle grasper and indocyanine green (ICG) fluorescence to perform dome resection of a huge nonparasitic splenic cyst in a pediatric patient.
A 13-year-old girl was incidentally diagnosed with a splenic cyst during follow-up for scoliosis. Abdominal enhanced computed tomography (CT) showed a 17 × 14 × 14 cm unifocal cyst. Laparoscopic dome resection was planned. The intraoperative findings showed that the spleen was distended, but there was no apparent prominence of the thin cyst wall on the surface of the spleen. An ICG fluorescence camera overlay revealed poor coloration in the thinning area. We punctured the area and aspirated the cyst contents. We grasped the cyst wall with a percutaneous needle grasper and dissected the cyst wall with a vessel sealing system. We placed anti-adhesion agent at the dissection line to prevent recurrence.
ICG fluorescence was useful for identifying the thinning area of a splenic cyst. The use of a percutaneous needle grasper facilitated the performance of dome resection of a huge splenic cyst in a pediatric patient with minimal invasiveness and an improved cosmetic outcome.
近年来，保留脾脏免疫功能的脾囊肿去顶术已成为治疗脾囊肿的主要技术。本文报告了一种使用针抓钳和吲哚菁绿（ICG）荧光来为一名儿科患者行巨大非寄生虫性脾囊肿去顶术的手术技术。
一名 13 岁女孩在脊柱侧凸随访中意外诊断出脾囊肿。腹部增强 CT 显示单发囊肿 17×14×14cm。计划行腹腔镜下脾囊肿去顶术。术中发现脾脏肿大，但脾脏表面无明显薄壁囊肿隆起。ICG 荧光摄像叠加显示该变薄区域着色不佳。我们对此处进行穿刺抽吸囊液。我们使用经皮针抓钳抓住囊肿壁，并用血管密封系统分离囊肿壁。我们在分离线处放置防粘连剂以防止复发。
ICG 荧光有助于识别脾囊肿的变薄区域。使用经皮针抓钳有助于微创、改善美容效果地为儿科患者行巨大脾囊肿去顶术。
