Removal of giant abdominal pseudocyst and laparoscopic bariatric surgery in a patient with morbid obesity

Abdominal wall pseudocyst is an infrequent complication that may arise after hernia repair. In most cases, obesity and the presence of prosthetic material are commonly recognised as significant risk factors. The giant pseudocyst is characterised by fluid collection that lacks an epithelial lining and has a diameter greater than 10 cm.We present the case of a male patient with an elevated body mass index, hypertension and a history of two umbilical hernia repairs using polypropylene mesh. This complication developed several years postsurgery. The management approach included complete excision of the pseudocyst, as well as laparoscopic vertical gastrectomy and abdominal wall repair with partially resorbable composite intraperitoneal mesh.We explore its multifaceted aetiology, risk factors, available treatment options and preventive measures. In this clinical case, indocyanine green fluorescence is used as an important tool to assess skin perfusion that can help guide associated dermolipectomy.