Morselator
For Laparoscopic Treatment of Large Hydatid Cyst of the Liver

Dr. Ahmad Al-Jaziri

The laparoscopic approach to the management of hydatid cyst disease of the liver is being increasingly used. One technique is the introduction of a Morselator suction device (Figure 1) which is placed directly into the endocyst of a large Hydatid cyst. (Figure 2).

Figure 1: Morselator suction device

Figure 2: Hydatid cyst of the liver

The parasite in the germinal layer is first killed by infiltrating hypertonic Saline (10%) down the morcelator. This device also helps by preventing the spillage of the fluid and tissue fragment contents of the cyst into the peritoneal cavity. (Fig 3).

Figure 3: Fluids/tissue fragments as the port into the cyst get sealed

The procedure is performed by placement of an umbilical telescope port followed by a 15mm port for the Morselator, which is placed adjacent to the cyst which can be in either the right or left lobe of liver. Once the cyst contents have be morselated and removed by suction, the morselatore is removed and the telescope placed into the resulting cavity to ensure complete removal of daughter cysts. A tube drain is then placed into the cavity to avoid post operative bile collection.

Laparoscopic fenestration and morselation is now the treatment of choice for either for either solitary or multiple hydatid liver cysts. It results in minimal surgical trauma, shorter operating times and reduced hospital stay. Complications of open of laparatomy and the risk of post operative adhesions are also reduced..

Reference

1. Laparoscopic Treatment of Symptomatic Hydatid Cyst of the Liver. BJS, Volume 85 No. 1, P.25 Jan 1998