Abstract
Giant peritoneal inclusion cysts have been excised via laparotomies. We report a case in which a giant peritoneal inclusion cyst was successfully evacuated by laparoscopic-assisted surgery after securing a visual field by transvaginal puncture. The patient was a 44-year-old woman who had been diagnosed with a uterine myoma at another hospital at 42 years of age; she underwent a total laparoscopic hysterectomy and laparoscopic right adnexectomy. She returned to the same hospital with a chief complaint of a lump in her abdomen of six months' duration; she was diagnosed with a left ovarian tumor and was referred to our hospital. A diagnosis of a peritoneal inclusion cyst was made, and laparoscopic-assisted surgery was performed. Because the lesion was too large to allow a laparoscopic visual field, 1,100 mL of fluid was removed from the cyst transvaginally. The bladder peritoneum and sigmoid mesocolon were then dissected; the cyst wall was then opened revealing normal left adnexa within it. Then, the surgery was completed by opening the pouch of Douglas. The patient's postoperative course was uneventful, and she was discharged on postoperative day 3. There have been no signs of recurrence. Laparoscopic-assisted surgery is a useful procedure for radical treatment of peritoneal inclusion cysts; however, it may be difficult to perform if the cyst is large. When a patient with such a cyst presents to us, we transvaginally puncture the cyst and evacuate it; thus, enabling safe and successful completion of laparoscopic-assisted surgery.
