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Surgical options consist primarily of either an anterior transabdominal or a posterior transsacral approaches. The main goal of surgery should be to safely disconnect the cyst from subarachnoid space to prevent further enlargement, thereby reducing the compression of nearby structures.   The anterior transabdominal approach could be performed via laparoscopic or open trans-abdominal/laparotomy  \cite{16793455} Several reports have stressed the advantages of the posterior transsacral technique, which offers (citas).