PMC3461775_01
(a) USG showing multilocular hydatid cyst. (b and c) CECT showing left renal hydatid with multiple daughter cysts
JSTCR-4-32-g001.jpg
PMC3461775_01_JSTCR-4-32-g001.jpg
F1
An ultrasonography of abdomen showed a large multilocular cyst replacing the left kidney, with floating membranes inside [Figure 1a]. A contrast-enhanced computed tomography (CECT) scan revealed the same findings without increase in enhancement or calcification of the cyst wall [Figure 1b and c].
Palanivelu hydatid system consisting of a cannula and a trocar
JSTCR-4-32-g002.jpg
PMC3461775_01_JSTCR-4-32-g002.jpg
F2
It is fenestrated at the tip and hollow throughout its length to accommodate a suction cannula [Figure 2]. It has two side channels, one for irrigation and another for suction [Figure 2 and 3a].
(a) Palanivelu hydatid system outer cannula consisting of two side channels for suction and irrigation. (b) Intraoperative placement of PHS over the surface of hydatid cyst. (c) Hydatid scolices seen through suction tube. (d) Renal hydatid cyst cut opened after surgical removal with aspiratedscolices and laminated membranes
JSTCR-4-32-g003.jpg
PMC3461775_01_JSTCR-4-32-g003.jpg
F3
It has two side channels, one for irrigation and another for suction [Figure 2 and 3a]. The cyst is isolated on all sides by packing it off using gauze pieces soaked with 10% povidone iodine, especially near the proposed site of introduction of the hydatid trocar and cannula, to minimize the spillage of the hydatid contents [Figure 3b]. Once inside the peritoneal cavity, the trocar is removed and the cannula alone is advanced till its tip reaches over the surface of the hydatid cyst [Figure 3b]. In this way, fragments of laminated membrane, daughter cysts, and debris are easily removed [Figure 3c and d].