跳至主要内容

Robotic Removal of a Hypogastric Splenic Cyst. A Case Report and Review of Literature

Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47226#.VFwusWfHRK0

Background: Splenic cysts are infrequent findings in everyday medical practice. They are usually associated with nonspecific symptoms and the diagnosis is incidental. In most instances they are located in the left subcostal region, except for cases of huge sized cysts which can extend to the whole abdomen or pelvis. Aim: To present a case of a large hypogastric splenic cyst in a nulliparous woman, managed with robotic cystectomy. Review of the literature is included. Case: A 19-year-old woman, presented to the gynecologic department with a painless, palpable mass in the lower abdomen. Ultrasonography revealed a pelvic cystic mass, originally misdiagnosed for an ovarian cyst. Serum biomarkers and β-hCG were negative. Definite diagnosis was made during explorative laparoscopy where the cyst was found to originate from the spleen. The surgery setup was changed from a lower to upper abdominal procedure. A robotically-assisted cystectomy was performed without concurrent splenectomy, and the splenic cavity was filled with an omental patch. There was no blood loss and the operation time was 163 minutes. Recovery was uneventful and there was no recurrence for a period of 16 months postoperatively. Conclusions: Pelvic splenic cysts are rare, and may be incidental findings during routine abdominal ultrasound scans. Modern minimally invasive approaches such as robotic surgery offer safe and efficient alternatives to standard techniques.
Cite this paper
Hirides, P. , Hirides, S. , Margeths, A. , Chrysoheris, P. , Antonakopoulos, F. and Konstantinidis, K. (2014) Robotic Removal of a Hypogastric Splenic Cyst. A Case Report and Review of Literature. Surgical Science, 5, 264-271. doi: 10.4236/ss.2014.56046. 
 

[1] Martin, J.W. (1958) Congenital Splenic Cysts. The American Journal of Surgery, 96, 302-308.
http://dx.doi.org/10.1016/0002-9610(58)90916-4
[2] Sellers, G.J. and Starker, P.M. (1997) Laparoscopic Treatment of a Benign Splenic Cyst. Surgical Endoscopy, 11, 766-768. http://dx.doi.org/10.1007/s004649900446
[3] Labruzzo, C., Haritopoulos, K.N., El Tayar, A.R. and Hakim, N.S. (2002) Posttraumatic Cysts of the Spleen: A Case Report. International Surgery, 87, 152-156.
[4] Hansen, M.B. and Moller, A.C. (2004) Splenic Cysts. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 14, 316-322. http://dx.doi.org/10.1097/01.sle.0000148463.24028.0c
[5] Trompetas, V., Panagopoulos, E., Priovolou-Papaevangelou, M. and Ramantanis, G. (2002) Giant Benign True Cyst of the Spleen with High Serum Level of CA 19-9. European Journal of Gastroenterology & Hepatology, 14, 85-88. http://dx.doi.org/10.1097/00042737-200201000-00015
[6] Macheras, A., Misiakos, E.P., Liakakos, T., Mpistarakis, D., Fotiadis, C. and Karatzas, G. (2005) Non-Parasitic Splenic Cysts: A Report of Three Cases. World Journal of Gastroenterology, 11, 6884-6887.
[7] Till, H. and Schaarschmidt, K. (2004) Partial Laparoscopic Decapsulation of Congenital Splenic Cysts. Surgical Endoscopy, 18, 626-628. http://dx.doi.org/10.1007/s00464-003-9046-4
[8] Robertson, F., Leander, P. and Ekberg, O. (2001) Radiology of the Spleen. European Radiology, 11, 80-95. http://dx.doi.org/10.1007/s003300000528
[9] Siniluoto, T.M., Paivansalo, M.J., Lahde, S.T., Alavaikko, M.J., Lohela, P.K., Typpo, A.B. and Suramo, I.J. (1994) Nonparasitic Splenic Cysts. Ultrasonographic Features and Follow-Up. Acta Radiologica, 35, 447-451.
[10] Nakashima, A., Nakashima, K., Seto, H., Kamei, T., Kakishita, M. and Kitagawa, M. (1994) Primary Splenic Lymphoma Presenting as a Large Cyst. Radiation Medicine, 12, 42-45.
[11] Cowles, R.A. and Yahanda, A.M. (2000) Epidermoid Cyst of the Spleen. The American Journal of Surgery, 180, 227. http://dx.doi.org/10.1016/S0002-9610(00)00446-3
[12] Andrews, M.W. (2000) Ultrasound of the Spleen. World Journal of Surgery, 24, 183-187.
http://dx.doi.org/10.1007/s002689910031
[13] Karfis, E.A., Roustanis, E. and Tsimoyiannis, E.C. (2009) Surgical Management of Nonparasitic Splenic Cysts. Journal of the Society of Laparoendoscopic Surgeons, 13, 207-212.
[14] Tagaya, N., Oda, N., Furihata, M., et al. (2002) Experience with Laparoscopic Management of Solitary Symptomatic Splenic Cysts. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 12, 279-282. http://dx.doi.org/10.1097/00129689-200208000-00016
[15] Smith, S.T., Scott, D.J., Burdick, J.S., et al. (2001) Laparoscopic Marsupialization and Hemisplenectomy for Splenic cysts. Journal of Laparoendoscopic & Advanced Surgical Techniques, 11, 243-249.
http://dx.doi.org/10.1089/109264201750539781
[16] Morgenstern, L. (2002) Nonparasitic Splenic Cysts: Pathogenesis, Classification, and Treatment. Journal of the American College of Surgeons, 194, 306-314. http://dx.doi.org/10.1016/S1072-7515(01)01178-4
[17] Pitiakoudis, M., Zezos, P., Oikonomou, A., Laftsidis, P., Kouklakis, G. and Simopoulos, C. (2011) Total Splenectomy due to an Unexpected “Complication” after Successful Extended Laparoscopic Partial Decapsulation of a Giant Epidermoid Splenic Cyst: A Case Report. Case Reports in Medicine, 318-208.
[18] Balzan, S.M., Riedner, C.E., Santos, L.M., Pazzinatto, M.C. and Fontes, P.R.O. (2001) Posttraumatic Splenic Cysts and Partial Splenectomy: Report of a Case. Surgery Today, 31, 262-265.
http://dx.doi.org/10.1007/s005950170183
[19] Matsutani, T., Uchida, E., Yokoyama, T., Matsushita, A., Matsuda, A. and Sasajima, K. (2009) Laparoscopic Unroofing of a Large Pseudocyst of the Spleen: Report of a Case. Journal of Nippon Medical School, 76, 319-322. http://dx.doi.org/10.1272/jnms.76.319
[20] Kaiwa, Y., Kurokawa, Y., Namiki, K., Matsumoto, H. and Satomi, S. (2000) Laparoscopic Partial Splenectomies for True Splenic Cysts. A Report of Two Cases. Surgical Endoscopy, 14, 865.
[21] Liu, K.K., Lee, K.H., Ku, K.W. and Yeung, C.K. (1996) Decapsulation of Symptomatic Splenic Pseudocyst—A Further Use for Laparoscopic Surgery in Children. The European Journal of Surgery, 162, 921-923.
[22] Sierra, R., Brunner, W.C., Murphy, J.T., Dunne, J.B. and Scott, D.J. (2004) Laparoscopic Marsupialization of a Giant Posttraumatic Splenic Cyst. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 8, 384-388.
[23] Dan, D., Bascombe, N., Harnanan, D., Hariharan, S. and Naraynsingh, V. (2010) Laparoscopic Management of a Massive Splenic Cyst. Asian Journal of Surgery, 33, 103-106.
http://dx.doi.org/10.1016/S1015-9584(10)60018-8
[24] Takata, M., Rader, C. and Kirton, O. (2007) Laparoscopic Marsupialization of a Giant Nonparasitic Splenic Cyst. Minimally Invasive Surgery Series.
http://www.hcplive.com/publications/surgical-rounds/2007/2007-05/2007-05_09
[25] Rotas, M., Ossowski, R., Lutchman, G. and Levgur, M. (2007) Pregnancy Complicated with a Giant Splenic Cyst: A Case Report and Review of the Literature. Archives of Gynecology and Obstetrics, 275, 301-305. http://dx.doi.org/10.1007/s00404-006-0229-9
[26] Madhu, B.S., Dinesh, H.N., Shashikumar, H.B., Kumar, V.K.P. and Naveen, S. (2012) Giant Pseudocyst of Spleen—A Rare Case Report. www.jemds.com
[27] Chang, H.M., et al. (2009) Huge Pseudocyst of the Spleen. Journal of Medical Sciences, 29, 269-271.
[28] Mertens, J., Penninckx, F., DeWever, I. and Topal, B. (2007) Long-Term Outcome after Surgical Treatment of Nonparasitic Splenic Cysts. Surgical Endoscopy, 21, 206-208.
http://dx.doi.org/10.1007/s00464-005-0039-3
[29] Salky, B., Zimmerman, M., Bauer, J., Gelernt, I. and Kreel, I. (1985) Splenic Cyst—Definitive Treatment by Laparoscopy. Gastrointestinal Endoscopy, 31, 213-215.
http://dx.doi.org/10.1016/S0016-5107(85)72049-4
[30] Chin, E.H., Shapiro, R., Hazzan, D., Katz, L.B. and Salky, B. (2007) A Ten-Year Experience with Laparoscopic Treatment of Splenic Cysts. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 11, 20-23.
[31] Kalogeropoulos, G., Gundara, J.S., Samra, J.S. and Hugh, T.J. (2013) Laparoscopic Stapled Excision of Non-Parasitic Splenic Cysts. ANZ Journal of Surgery, Early View. http://dx.doi.org/10.1111/ans.12367
[32] Smith, S.T., Scott, D.J., Burdick, J.S., Rege, R.V. and Jones, D.B. (2001) Laparoscopic Marsupialization and Hemisplenectomy for Splenic Cysts. Journal of Laparoendoscopic & Advanced Surgical Techniques, 11, 243-249. http://dx.doi.org/10.1089/109264201750539781
[33] Fan, H., Zhang, D., Zhao, X., Pan, F. and Jin, Z.K. (2011) Laparoscopic Partial Splenectomy for Large Splenic Epidermoid Cyst. Chinese Medical Journal (English), 124, 1751-1753.
[34] Hery, G., Becmeur, F., Mefat, L., Kalfa, D., Lutz, P., Lutz, L., et al. (2008) Laparoscopic Partial Splenectomy: Indications and Results of a Multicenter Retrospective Study. Surgical Endoscopy, 22, 45-49. http://dx.doi.org/10.1007/s00464-007-9509-0
[35] Szczepanik, A.B. and Meissner, A.J. (2009) Partial Splenectomy in the Management of Nonparasitic Splenic Cysts. World Journal of Surgery, 33, 852-856. http://dx.doi.org/10.1007/s00268-008-9868-2
[36] Wu, S.C., Wang, C.C. and Yong, C.C. (2007) Partial Splenectomy for Benign Splenic Cysts with the Aid of a Lin Clamp: Technical Note. World Journal of Surgery, 31, 2144-2147.
http://dx.doi.org/10.1007/s00268-007-9240-y
[37] Uranues, S. and Alimoglu, O. (2005) Laparoscopic Surgery of the Spleen. Surgical Clinics of North America, 85, 75-90. http://dx.doi.org/10.1016/j.suc.2004.09.003
[38] Rosin, D., Brasesco, O. and Rosenthal, R.J. (2001) Laparoscopic Splenectomy: New Techniques and Indications. Der Chirurg, 72, 368-377. http://dx.doi.org/10.1007/s001040051317
[39] Uccheddu, A., Pisanu, A., Cois, A., et al. (2003) Laparoscopic Management of Non-Parasitic Splenic Cysts. Chirurgia Italiana, 55, 55-60.
[40] Kiriakopoulos, A., Tsakayannis, D., Papadopoulos, S. and Linos, D. (2005) Laparoscopic Management of a Ruptured Giant Epidermoid Splenic Cyst. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 9, 349-351.
[41] Sakamoto, Y., Yunotani, S., Edakuni, G., Mori, M., Iyama, A. and Miyazaki, K. (1999) Laparoscopic Splenectomy for a Giant Splenic Epidermoid Cyst: Report of a Case. Surgery Today, 29, 1268-1272. http://dx.doi.org/10.1007/BF02482221
[42] Ma, J.P., Cai, S.R., Wu, K.M., Liao, B. and Zhan, W.H. (2011) Giant Epithelial Splenic Cyst. Chinese Medical Journal (English), 124, 2799-2800.
[43] Shukla, R.M., Mukhopadhyay, M., Mandal, K.C. and Mukhopadhyay, B. (2010) Giant Congenital Infected Splenic Cyst: An Interesting Case Report and Review of the Literature. Indian Journal of Surgery, 72, 260-262. http://dx.doi.org/10.1007/s12262-010-0068-6
[44] Uludag, M., Yetkin, G., Citgez, B., Karakoc, S., Polat, N. and Yener, S. (2009) Giant True Cyst of the Spleen with Elevated Serum Markers, Carbohydrate Antigen 19-9 and Cancer Antigen 125. BMJ Case Reports.
[45] Chiarugi, M., Galatioto, C., Battini, A., Panicucci, S., Lippolis, P. and Seccia, M. (2006) Giant Epidermoid Cyst of the Spleen with Carbohydrate and Cancer Antigen Production Managed Laparoscopically. Annali Italiani di Chirurgia, 77, 443-446.
[46] Ward, E.V., O’brien, J., Conlon, K. and Torreggiani, W.C. (2010) Unusual Long-Term Complications of a Splenic Cyst. JBR-BTR, 93, 7-9.
[47] Sinha, C.K. and Fisher, R. (2006) Splenoptosis Complicated by a Large Splenic Cyst: Case Report and Discussion of Combined Management. Pediatric Surgery International, 22, 605-607.
http://dx.doi.org/10.1007/s00383-006-1673-0
[48] Lucandri, G., Felicioni, F., Monsellato, I., Alfano, G., Pernazza, G., Pende, V., et al. (2011) Robotic Splenectomy for Mesothelial Cyst: A Case Report. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 21, e93-e96. http://dx.doi.org/10.1097/SLE.0b013e31820b8a7c
[49] Vasilescu, C., Tudor, S., Popa, M., Tiron, A. and Lupescu, I. (2010) Robotic Partial Splenectomy for Hydatid Cyst of the Spleen. Langenbeck’s Archives of Surgery, 395, 1169-1174.
http://dx.doi.org/10.1007/s00423-010-0647-9
[50] Fedorov, A.V., Kriger, A.G., Berelavichus, S.V., Efanov, M.G. and Gorin, D.S. (2010) [Robotic-Assisted Abdominal Surgery]. Khirurgiia (Mosk), 16-21.
[51] Tomulescu, V., St?nciulea, O., B?lescu, I., Vasile, S., Tudor, S., Gheorghe, C., et al. (2009) First Year Experience of Robotic-Assisted Laparoscopic Surgery with 153 Cases in a General Surgery Department: Indications, Technique and Results. Chirurgia (Bucur), 104, 141-150.     eww141107lx
标签：

评论

发表评论

此博客中的热门博文

A Comparison of Methods Used to Determine the Oleic/Linoleic Acid Ratio in Cultivated Peanut (Arachis hypogaea L.)

Cultivated peanut ( Arachis hypogaea L.) is an important oil and food crop. It is also a cheap source of protein, a good source of essential vitamins and minerals, and a component of many food products. The fatty acid composition of peanuts has become increasingly important with the realization that oleic acid content significantly affects the development of rancidity. And oil content of peanuts significantly affects flavor and shelf-life. Early generation screening of breeding lines for high oleic acid content greatly increases the efficiency of developing new peanut varieties. The objective of this study was to compare the accuracy of methods used to classify individual peanut seed as high oleic or not high oleic. Three hundred and seventy-four (374) seeds, spanning twenty-three (23) genotypes varying in oil composition (i.e. high oleic (H) or normal/not high oleic (NH) inclusive of all four peanut market-types (runner, Spanish, Valencia and Virginia), were individually tested ...
发表评论
阅读全文

Location Optimization of a Coal Power Plant to Balance Costs against Plant’s Emission Exposure

Fuel and its delivery cost comprise the biggest expense in coal power plant operations. Delivery of electricity from generation to consumers requires investment in power lines and transmission grids. Placing a coal power plant or multiple power plants near dense population centers can lower transmission costs. If a coalmine is nearby, transportation costs can also be reduced. However, emissions from coal plants play a key role in worsening health crises in many countries. And coal upon combustion produces CO 2 , SO 2 , NO x , CO, Metallic and Particle Matter (PM10 & PM2.5). The presence of these chemical compounds in the atmosphere in close vicinity to humans, livestock, and agriculture carries detrimental health consequences. The goal of the research was to develop a methodology to minimize the public’s exposure to harmful emissions from coal power plants while maintaining minimal operational costs related to electric distribution losses and coal logistics. The objective was...
发表评论
阅读全文

Evaluation of the Safety and Efficacy of Continuous Use of a Home-Use High-Frequency Facial Treatment Appliance

At present, many home-use beauty devices are available in the market. In particular, many products developed for facial treatment use light, e.g., a flash lamp or a light-emitting diode (LED). In this study, the safety of 4 weeks’ continuous use of NEWA TM , a high-frequency facial treatment appliance, every alternate day at home was verified, and its efficacy was evaluated in Japanese individuals with healthy skin aged 30 years or older who complained of sagging of the facial skin.  Transepidermal water loss (TEWL), melanin levels, erythema levels, sebum secretion levels, skin color changes and wrinkle improvement in the facial skin were measured before the appliance began to be used (study baseline), at 2 and 4 weeks after it had begun to be used, and at 2 weeks after completion of the 4-week treatment period (6 weeks from the study baseline). In addition, data obtained by subjective evaluation by the subjects themselves on a visual analog scale (VAS) were also analyzed. Fur...
发表评论
阅读全文