CHENNAI: Doctors from MIOT hospitals removed a rare giant intra-abdominal cyst from a four-year-old Fijian boy. The procedure, which may have required opening of the abdomen with a large slit, was done using laparoscopy, leaving minimal scars. Slits that were smaller than a centimetre were used to remove the cyst, said Dr M Ragavan, paediatric surgeon, who operated on the boy.
Arnav was first diagnosed with hernia when he was barely 10 months old. When he was about 1.5 years old, doctors from the government hospital in Fiji performed an umbilical hernia surgery, which was followed by two other surgeries in the following year. But, Arnav’s condition did not improve.
Investigations on Arnav revealed an intra-abdominal fluid-filled cyst in his abdomen. “Only one in one lakh persons develop a lymphatic cyst. Most patients develop cysts under the armpits or near the neck. Only five per cent of all lymphatic cysts grow in the abdomen,” said Dr Ragavan.
The cyst that was about 10-cm wide, a year ago grew into an 18-cm wide structure. It had not only pushed other organs such as liver and urinary bladder to the periphery, but also applied pressure on the abdominal walls causing pains. “We did not want to open his abdomen up because he’s a young boy. It would have left a large permanent scar,” said Dr Ragavan.
Instead, a laparoscopic camera was sent in through an incision above his belly button. Two more incisions were made on either side of the belly button to insert the surgical equipment. “We cut the surface of the cyst first, removed the fluid inside, then pulled out the growth through the slits,” he said.
The surgery was performed for about two hours, after administering a general anaesthesia by Dr Sarva Vinothini, paediatric anaesthetist. “He recovered fully in a day and started having a good appetite,” she said. Arnav has gained nearly three kilograms in two weeks after the surgery, according to medical records. The surgery cost the family about `2 lakh.
Flown in from Fiji
Arnav’s mother Sonam Prasad told Express that doctors in Fiji had advised Arnav’s parents to remove the cyst at a later stage, when he was older, and that he could not be operated in the government hospital in Fiji’s capital Suva. “He was constantly in pain, and he was always underweight. He would not eat anything when he had bad stomach pain,” Sonam said, adding that she could not see her son suffer anymore. She and her husband then flew him to India to be treated at MIOT.