Laparoscopic Surgery of the Spleen

Abstract

Splenectomy may be indicated in the treatment of a number of diseases including benign and malignant hematological conditions, cysts, trauma or splenic aneurysms. An organ situated deep in the left hypochondrium and difficult to access, the spleen remains poorly understood with regard to its physiology and function. Delaitre (Paris), Carroll (Los Angeles) and Poulin (Montreal) were the first to report successful laparoscopic splenectomy in humans. The spleen is a fragile and highly vascularized organ, receiving as much as 20 % of the cardiac output. Many hematological diseases for which splenectomy may be indicated are associated with a reduced platelet count, which increases the risk of bleeding and spleen enlargement. As well as being deeply recessed, the spleen is directly attached to several organs. These factors all contribute to the level of difficulty in the performance of laparoscopic splenectomy and advanced training on the part of the surgeon is required.