Dr. Najeeh Al-Khaldi, a general surgery consultant at the hospital, led the team. With him worked Dr. Durgham Hamadneh, Dr. Muhammad Mubarak and Dr. Muhammad Musaaadah; anaesthesia was in the hands of Dr. Muhammad Al-Rawashdeh and the resident Dr. Osama Bashtawi. The cyst came out whole enough, and the woman kept her abdominal wall intact.
The reason such operations are usually done open has nothing to do with the size of the cyst and everything to do with its contents. Hydatid fluid carries protoscolices — hundreds of thousands in a single cyst, settling as a sediment surgeons call hydatid sand. Every one of them can seed a new cyst if it escapes into the abdominal cavity. A leak can also send a patient into anaphylaxis on the table. Surgeons pack the field with pads soaked in hypertonic saline, aspirate before they open, and give albendazole before and after. Guaranteeing all of that through narrow ports is harder, which is why the laparoscopic route came late to this disease; the first published series appeared only in the mid-1990s.
The disease belongs to the landscape around Irbid. The northern highlands are sheep country, and Echinococcus granulosus travels a quiet circuit there: dogs eat infected offal, shed eggs in their faeces, and a human picks them up from hands, water or unwashed produce. The person becomes a dead end for the parasite and a patient for the surgeon. The World Health Organization files it among the neglected tropical diseases.
Hospital director Dr. Walid Al-Halabi said the approach spared the patient pain and shortened her recovery. Princess Basma is a Ministry of Health facility and one of the main public referral centres for the north — the hospital people in the surrounding villages reach when something has been pressing on them for years.