Description

Hydatid cyst disease, also known as echinococcosis, is a parasitic infection caused by the larval stage of Echinococcus species, most commonly Echinococcus granulosus. It is a significant health concern in regions where livestock farming is prevalent, and humans act as accidental hosts. Understanding its pathophysiology, diagnosis, and management is crucial for surgeons, particularly those practicing minimally invasive techniques. In his lecture, Dr. R K Mishra, a pioneer in laparoscopic and robotic surgery, provided an in-depth overview of hydatid cyst disease, combining classical surgical principles with advanced minimally invasive approaches. Dr. Mishra emphasized the importance of early diagnosis, careful preoperative planning, and meticulous surgical technique to prevent complications such as cyst rupture, anaphylaxis, or dissemination. The lecture highlighted several key areas: Epidemiology and Etiology Hydatid disease is most prevalent in sheep- and cattle-raising regions. Humans become infected through ingestion of parasite eggs via contaminated food, water, or direct contact with definitive hosts such as dogs. Clinical Features Often asymptomatic for years due to the slow growth of cysts. Symptomatic patients may present with abdominal pain, hepatomegaly, or pressure effects depending on cyst location. Diagnostic Modalities Ultrasound is the first-line imaging for hepatic cysts, often revealing characteristic daughter cysts. CT and MRI provide detailed information on size, location, and complications. Serological tests can support diagnosis but are not definitive. Surgical Management Traditional open surgery remains effective but carries higher morbidity. Dr. Mishra highlighted laparoscopic management of hydatid cysts, which reduces postoperative pain, hospital stay, and recovery time. Principles include careful isolation of the cyst, avoidance of spillage, and use of scolicidal agents. Complications and Their Prevention Cyst rupture, infection, and anaphylactic reactions are major risks. Proper technique and meticulous preoperative preparation are essential to minimize these risks. Postoperative Care and Follow-up Antiparasitic therapy, such as albendazole, is recommended pre- and post-operatively in selected cases. Regular imaging follow-up ensures early detection of recurrence. Dr. R K Mishra’s lecture also included case studies demonstrating the practical application of laparoscopic techniques in hydatid cyst surgery, highlighting his innovative approaches and expertise. He emphasized that with proper technique and careful patient selection, laparoscopic management of hydatid cysts is safe, effective, and increasingly becoming the standard of care. This lecture serves as a valuable resource for surgeons, residents, and healthcare professionals seeking a comprehensive understanding of hydatid cyst disease and its modern surgical management.