Laparoscopic Argon-Beam Coagulation in Relapsing Congenital Dysontogenic Splenic Cysts

We operated on a 13-year-old girl with an upper abdominal mass caused by growing congenital dysontogenetic cysts in the lower part of the spleen. The first operation was done laparoscopically using a bare Nd:YAG laser fiber and the Harmonic Scalpel. All cystic material was removed, and the surface of the remainder of the spleen was covered with greater omentum. Because of relapse within weeks, the operation had to be redone 3 months later. This time, the remaining splenic surface was treated with a 5-mm laparoscopic argon-beam coagulator. No relapse has occurred in the ensuing 2 years. Any laparoscopic use of the argon-beam coagulator carries a risk of argon gas embolization. Despite this risk, with appropriate precautions, the coagulator is a very helpful tool for the treatment of splenic cysts.