Laparoscopic marsupialization of the difficult lymphocele using internalized peritoneal dialysis catheter

Purpose: Definitive treatment of the recurrent or anatomically difficult lymphocele without a common wall between the lymphocele and peritoneal cavities requires open surgery. We present a novel technique of laparoscopic marsupialization of such lymphoceles with placement of a cable of 2 internalized peritoneal dialysis catheters for maintaining permanent lymphoperitoneal drainage. Materials and Methods: Two patients with a symptomatic, post-renal transplant pelvic lymphocele underwent the procedure. Laparoscopic marsupialization was performed with ultrasound guidance and in each case a cable of 2 internalized peritoneal dialysis catheters was anchored through the limited peritoneal window to maintain lymphoperitoneal drainage. Results: Both procedures were successful. During a followup of 20 and 21 months, respectively, no recurrence or infectious complications were noted in these immunocompromised patients. Conclusions: Laparoscopic marsupialization with internalization of peritoneal dialysis catheters is a feasible, alternative measure available for select cases with a difficult or recurrent lymphocele.