LAPAROSCOPIC TREATMENT OF LIVER HYDATID CYSTS

We report the laparoscopic use of a novel perforator-grinder-aspirator apparatus, specifically designed for the evacuation of hydatid cysts. Eleven hepatic hydatid cysts in six patients were treated by laparosc opic technique using this tool, which penetrates the cyst mainly by op ening a hole in the cyst wall, grinds the particulate, and sucks it al l out; classic surgical aspirators are almost always blocked by daught er cysts and laminated membranes. If the cyst is small, management of the cavity is achieved by simple drainage; otherwise, vacuum obliterat ion with the application of - 250-mbar negative pressure may be necess ary. High vacuum obliterates the cystic cavity by clinging to the oppo sing cyst walls. In the postoperative period, none of these patients h ad bile drainage. In the following 6 to 20 months period, computed tom ography (CT) and ultrasound examinations revealed progressive decrease in the size of seven cysts and disappearance of the lesions in five c ysts. We therefore conclude that laparoscopic treatment of hepatic hyd atid cysts can be easily and effectively accomplished by using this no vel instrument. Obliteration of the cystic cavity by high vacuum is a time-saving procedure that is easy to perform and that reduces or tota lly eliminates bile drainage.