Laparoscopic marsupialization of the difficult lymphocele using internalized peritoneal dialysis catheter

Purpose: Definitive treatment of the recurrent or anatomically difficult ly mphocele without a common wall between the lymphocele and peritoneal caviti es requires open surgery. We present a novel technique of laparoscopic mars upialization of such lymphoceles with placement of a cable of 2 internalize d peritoneal dialysis catheters for maintaining permanent lymphoperitoneal drainage. Materials and Methods: Two patients with a symptomatic, post-renal transpla nt pelvic lymphocele underwent the procedure. Laparoscopic marsupialization was performed with ultrasound guidance and in each case a cable of 2 inter nalized peritoneal dialysis catheters was anchored through the limited peri toneal window to maintain lymphoperitoneal drainage. Results: Both procedures were successful. During a followup of 20 and 21 mo nths, respectively, no recurrence or infectious complications were noted in these immunocompromised patients. Conclusions: Laparoscopic marsupialization with internalization of peritone al dialysis catheters is a feasible, alternative measure available for sele ct cases with a difficult or recurrent lymphocele.