Single-incision laparoscopic ileo-cecal resection for appendiceal mucocele

Abstract

Mucocele of the appendix is a rare lesion which denotes a distension of the lumen due to accumulation of mucoid substance, and a possible rupture of the mucocele may result in the clinical condition of pseudomyxoma peritonei. Therefore, the laparoscopic approach for this disease is still controversial because improper handling may cause inadvertent rupture. We present a successfully treated case with the singleincision laparoscopic approach. An 88-year-old man was diagnosed with the mucocele of the appendix, and we decided to perform the single incision laparoscopic ileocecal resection. First, a lap protector was inserted through a 3.0 cm transumbilical incision. Three 5 mm ports were placed in EZ access mounted on the lap protector. On the observation of laparoscopy, a retrocecal appendix was found. We successfully mobilized the right colon and transected the ileum using an endoscopic linear stapler. The right colon with appendix was carefully extracted through the umbilical incision. Resection and anastomosis were achieved following extracorporealization. The appendix was measured 7 cm in length and 3 cm in diameter; a final histopathological diagnosis was mucocele caused by mucinous cystadenoma. This is, to our knowledge, the first case of a single-incision laparoscopic ileocecal resection for mucocele of the appendix described in the indexed literature. © Association of Surgeons of India 2012.