Sonoguided Percutaneous Endoscopic Evacuation and Drainage (SPEED) Technique: Report of a Novel Surgery for Hydatid Cyst
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SURGICAL TECHNIQUES AND INNOVATIONS
Sonoguided Percutaneous Endoscopic Evacuation and Drainage (SPEED) Technique: Report of a Novel Surgery for Hydatid Cyst of the Liver Joy Abraham 1
&
Maulik Bhadaniya 1 & Mayank Sharma 1 & Devendra Talera 1 & Hasmukh Vora 1 & Premal Desai 1
Received: 3 July 2020 / Accepted: 15 August 2020 # Association of Surgeons of India 2020
Abstract The spectrum of treatment for hydatid cyst varies from medical therapy, surgery, radiology-guided intervention to laparoscopy. Initially surgery was considered the gold standard. However, in the last few decades, percutaneous interventional therapy has been proved to be an effective and safe alternative to open surgery. Despite being the last entrant, laparoscopy has set significant standards in the care of hydatid disease. We describe a novel technique for the treatment of hydatid cyst of the liver. The technique is called Sonoguided Percutaneous Endoscopic Evacuation and Drainage (SPEED) (https://youtu.be/ietvpAuxzDo). This is based on the PAIR technique of sonography-guided puncture followed by introduction of rigid scope into the cyst. The technique was successful in the patient in terms of cyst evacuation and successful short-term outcome. The advantage of this procedure is that though minimally invasive, the procedure is very aggressive in terms of complete cyst evacuation. Thus, it can be a suitable replacement for the PAIR procedure, thereby increasing the chances of cure. The validation of the process is in progress. Keywords SPEED . Laparoscopy . Hydatid . Liver . PAIR . Sonography guided . Percutaneous
Introduction Hydatid cyst caused by Echinococcus granulosus is one of the few infectious diseases with a surgical treatment [1]. The armamentarium for the treatment of hydatid cyst varies from
* Joy Abraham [email protected] Maulik Bhadaniya [email protected]
medical therapy to interventional therapy expanding to laparoscopy and open surgery. The gold standard for the treatment of hydatid cyst has varied with times. Initially open surgery was considered the gold standard. However, in the last few decades, percutaneous interventional therapy has been proved to be an effective and safe alternative to open surgery [2]. Despite being the last entrant, laparoscopy has set significant standards in the care of hydatid disease [3]. In this article, we present a novel form of endoscopy which we propose to be minimally invasive like PAIR but more aggressive and complete techniques like cystopericystectomy.
Mayank Sharma [email protected] Devendra Talera [email protected] Hasmukh Vora [email protected] Premal Desai [email protected] 1
Department of Surgical Gastroenterology, NHL Medical College & SVP Hospital, Paldi, Ahmedabad, Gujarat 380015, India
Methods and Technique We present the video case of a 55-year-old female patient who presented with symptomatic hydatidosis of the liver. Ultrasonography was suggestive of 8 × 7-cm multiloculated hydatid cyst on the right lobe of the liver, CE type 3B, W
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