Introduction/Background Asymptomatic lymphocele formation after lymphadenectomy is quite common but in some symptomatic cases surgical intervention is essential to relieve the symptoms.
Methodology Video presentation of case
Results 51 year old woman with postmenopausal bleeding was subjected to laparoscopic staging (laparoscopic hysterectomy + BSO + pelvic and paraaortic lymphadenectomy) who had grade III endometrioid adenocarcinoma of uterus in her endometrial biopsy. Intraoperatively in paraaortic lymphadenectomy an incidental injury to cisterna chyli occurred which was sealed and repaired immediately. She was discharged in post-op day 2. Three day after her discharge she referred to our clinic once again with complaints of right lower back-pain. Ultrasonographic evaluation revealed grade 2–3 hydroureteronephrosis (HUN). In CT scan a 5 cm lymphocele located in paraaortic area was observed which causes ureteral obstruction at that level. Because of the sympyoms and HUN re-laparoscopy was planned. Laparoscopically lymphocele located laterally in right low-paraaortic region was detected and aspirated. A window was created in the lymphocel sac in order to prevent recureence. In postoperative period the patient developed ileus which was handled conservatively. In P.O. day 4 she was discharged without any symptoms. One week after re-laparoscopy complete resolution of HUN was confirmed and she was referred to brachytherapy unit.
Conclusion Laparoscopy is a useful and safe tool in the management of symptomatic lymphocele. With minimally invasive techniques recovery is fast and there is no delay in the planned adjuvant therapy.
Disclosure Nothing to disclose
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