Surgical Excision of Mesenteric Cyst
Surgical Excision of Mesenteric Cyst is done to remove the Mesenteric cysts which are rare surgical condition
Some facts about Surgical Excision of Mesenteric Cyst:
- Any cyst located in the mesentery.
- The cyst may or may not extend into the retroperitoneum, which has a recognizable lining of endothelium or mesothelial cell.
- Mesenteric cyst can occur anywhere from duodenum to rectum in the mesentery of gastrointestinal tract.
- Mesenteric cysts can be unilocular or multilocular, simple or multiple, and they may contain hemorrhagic, chylous, serous or infected fluid.
- They can range from a few millimetres to few cm in diameter in size.
- Mesenteric cyst may occur at any age and most commonly occur in the small bowel mesentery on the mesenteric side of the bowel .
- Complete history, clinical examination, blood investigations and radiological investigations including X-ray abdomen erect, ultrasound abdomen (USG) and computed tomography (CT) scan in selected cases are done to evaluate and diagnose Mesenteric cyst.
- Volvulus, spillage of infective fluid, herniation of bowel into an abdominal defect, and obstruction are secondary complications associated with mesenteric cysts.
- Complete excision of Mesenteric cyst should be done to avoid recurrence and possible malignant transformation.
- Bowel resection may also be done in case the cysts are close to bowel structures or involve blood vessels that supply the bowel.
- Mesenteric cysts rarely recur, after the removal.
- Damage to the mesenteric vessels can be avoided by taking out the cyst from between the leaves of the mesentery with care.
- The cyst may present either as an incidental finding, as non-specific abdominal feature or as an acute abdomen.
- Although patients may experience lower abdominal pain and symptoms that are frequently associated with other abdominal conditions, they are often asymptomatic and found incidentally while patients are undergoing work-up or receiving treatment for other conditions, such as appendicitis, small-bowel obstruction, or diverticulitis.
- Pain, nausea and vomiting, constipation, and diarrhoea are some of the symptoms which are variable and non-specific.
Preparation for Surgical Excision of Mesenteric Cyst:
- Avoid eating and drinking anything at least four hours before your surgery.
- You may drink a sip of water with your medications if needed.
- Any history of bleeding disorders or are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting should be informed to your healthcare provider as you may be asked to stop taking these medicines before your surgery.
- The possible complications and side effects, the risks, and what the operation involves will be discussed with you by your doctor.
Procedure for Surgical Excision of Mesenteric Cyst:
- Resection of these cysts can be achieved without full laparotomy by laparoscopic surgery.
- Four ports are used in laparoscopic exploration after insufflation with Veress needle.
- Cautery scissors and blunt dissection are used for excision of cyst.
- Endobags are used to retrieve the cyst.
- Concomitant bowel resection may be required in order to ensure that the blood supply to the bowel is not compromised.
- The dissection can be done with an incision of the peritoneal covering in the cephalic aspect of the mass at its superior margin.
- Ultrasonic dissection can be used to peeled away the mass from the underlying fat tissue.
- The small vessels to and from the cyst were progressively sealed and divided.
- Care must be taken during the detachment of the cyst from the superior mesenteric vessels, which were particularly attached to the right side of the cyst itself.
