PMC9768222_01
Computed tomography scan of the of giant paratubal cyst of 196 mm x 90 mm x 267 mm, coming from the pelvis and occupying all the four abdominal quadrants (A) and causing a IV grade hydronephrosis on the right kidney (B).
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F1
In order to better characterize the mass, the patient underwent abdominal computed tomography (CT) scan that reported a voluminous endoabdominal lesion of 196 mm x 90 mm x 267 mm coming from the pelvis and occupying all the four abdominal quadrants (Figure 1A). Moreover, it caused renal, bladder, and urinary tract compression causing a grade IV hydronephrosis on the right kidney (Figure 1B).
Laparoscopic appearance of part of the giant paratubal cyst (A) and of the convoluted left tube (B).
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F2
At inspection, a left paraovarian lesion occupying the whole pelvis until the transpyloric plane was detected (Figure 2A). The left tube showed multiple torsions around its axis causing lymphatic and vascular congestion (Figure 2B).
Alexis XS retractor inserted at the level of the umbilical access in order to carefully puncture the cyst using a suction irrigation apparatus (A), and extracorporeal cyst excision (B).
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F3
The cyst was carefully punctured and using a suction irrigation apparatus, a total of 2800 cc of fluid was aspirated from the cyst with no spillage (Figure 3A). At this point, we performed extracorporeal cyst excision (Figure 3B).