Here we show our technique on laparoscopic treatment of liver hydatid cyst.

2. Arch Surg. 2002 Oct;137(10):1170-3. Laparoscopically treated liver hydatid cysts. Ertem M, Karahasanoglu T, Yavuz N, Erguney S. Department of General Surgery, Cerrahpasa Medical School, University of Istanbul, Goztepe/Istanbul, Turkey. mertem@istanbul.edu.tr Abstract HYPOTHESIS: Laparoscopy is effective and reliable in treating hepatic hydatid disease. DESIGN: Case series of patients with hepatic hydatid disease who underwent laparoscopic treatment within 7 years. SETTING: Department of General Surgery, Cerrahpasa Medical School, University of Istanbul, Istanbul, Turkey. PATIENTS: Forty-eight patients with hydatid disease who met our criteria for laparoscopic surgery and were aged 17 years or older. INTERVENTIONS: Cystotomy and partial cystectomy with drainage were performed in 33 patients. Omentoplasty was simultaneously performed in 15 patients to obliterate the cystic cavity. MAIN OUTCOME MEASURES: Clinicopathologic features, morbidity, mortality, operative time, length of hospital stay, conversion to laparotomy, and recurrences were reviewed retrospectively. RESULTS: The mean operative time was 82 minutes (range, 45-170 minutes). The conversion rate to open surgery was 4%. The mean postoperative length of hospital stay was 4.2 days. Morbidity was 6% (3 patients). There was no mortality. The mean follow-up was 34.2 months. No recurrences were observed during this period. CONCLUSIONS: Laparoscopic hepatic hydatid surgery is a safe and effective method in selected patients. Further studies should be encouraged in this field because there is no universally accepted standard technique.

3. Dig Surg. 1998;15(4):333-6. Laparoscopic approach to hepatic hydatid disease. Ertem M, Uras C, Karahasanoglu T, Erguney S, Alemdaroglu K. Departments of Surgery, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey. Abstract BACKGROUND: The aim of this paper is to present our brief experience on laparoscopic hydatid cyst surgery; we estimated the reproducibility of used techniques in conventional surgery with this relatively recent and attractive method. METHODS: Fifteen cysts in 12 selected hydatid disease patients were treated laparoscopically. Cystotomy, partial cystectomy and drainage were performed in 9 patients. Omentoplasty was added to the procedure in the remaining 3 cases. RESULTS: The mean postoperative hospital stay was 4.9 days. There was no mortality, and 1 patient developed bile leakage. Mean follow-up is 18 months. No recurrence was observed during this period. CONCLUSION: We suggest that laparoscopic treatment of hydatid disease is feasible in selected patients respecting the principles of open surgery and seems beneficial concerning postoperative comfort, hospital stay and return to daily activities. PMID: 9845609 [PubMed - indexed for MEDLINE]

4. First trokar is inserted from umbilicus and exploratted the abdominal cavity . After then the other trokars are inserted to the position of the cyst.

5. Two suction instruments for security

6. To prevent any spilled of the cystic material , gauzes are placed to the sides of the cyst and then they suck the scolecidal solutions.

8. Aspiration nidelle

9. Puncture of the cyst with needle

10. Puncture of the cyst

11. Aspiration of the cyst

13. The cyst collapses as a result of aspiration

15. Germinal membrane

17. If the cyst position is suitable, germinal membrane can be placed into the endobag

18. Germinative membrane are placed into the endo-bag.

19. Endo-bag is taken out from the abdominal cavity through trocar

21. Cavity is irrigated with povidine-iodure and saline solutions

23. Un-roofing or partial cystectomy is performed

24. Partial cystectomy is performed and the drain is placed . If the cavity is big Omentoplasty can be done.

25. CT image before operation

26. CT image after operation

27. If the cyst is in a difficult position , wide suction tube is inserted in the cyst cavity . So the germinal membrane is aspirated rapidly, safely and in one lot. The 15 mm diameter suction tube is used through the 18 mm trocar.

28. the rigid thoracic tube with 15 mm inner diameter is used. The tube is connected to the suction device directly without any trumpet mechanism.

29. If the cyst is located at on the posterior side or at the dome of the liver . Flexible 15 mm tube can be used.

30. 32 F thoracic tube easily can be used