Abstract
Purpose
Laparoscopic splenectomy is challenging in patients with massive splenomegaly. The paper describes a technique that overcomes the difficulties one faces while dealing with a massive spleen laparoscopically.
Methods
We describe our splenic no-touch technique through the anterior lienorenal approach in patients undergoing laparoscopic splenectomy for massive splenomegaly during a 10-year period from January 2010 to January 2020.
Results
During the study period, 14 patients underwent laparoscopic splenectomy for massive splenomegaly. Of these, 13 patients had successful laparoscopic completion of the procedure. One patient required conversion for bleed. There were no pancreatic tail injuries during splenic hilar stapling in any patient. The median operative time was 170 minutes (140–225). The median blood loss was 50 mL (20–600). Two patients required blood transfusions. There was no other morbidity or mortality. The median postoperative stay was 2 days.
Conclusion
The splenic no-touch technique using the anterior lienorenal approach for laparoscopic splenectomy is safe and feasible in patients with massive splenomegaly. Preoperative imaging enables optimal port placement and procedure ergonomics.
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Change history
16 February 2023
A Correction to this paper has been published: https://doi.org/10.1007/s00423-023-02824-5
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The authors acknowledge Dr. Ravikiran Thota for his assistance with video editing.
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All authors are in agreement with the content of the manuscript. Conception: Srikanth Gadiyaram. Drafting of the manuscript: Srikanth Gadiyaram. Supplementary material: Murugappan Nachiappan, Srikanth Gadiyaram. Critical review: Srikanth Gadiyaram, Murugappan Nachiappan. Final approval: Srikanth Gadiyaram, Murugappan Nachiappan. Accountability: Srikanth Gadiyaram, Murugappan Nachiappan
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Gadiyaram, S., Nachiappan, M. Laparoscopic splenectomy for massive splenomegaly: the “splenic no-touch” technique for hilar control by anterior lienorenal approach. Langenbecks Arch Surg 408, 30 (2023). https://doi.org/10.1007/s00423-023-02800-z
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DOI: https://doi.org/10.1007/s00423-023-02800-z