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Laparoscopic Spleen Surgery: Procedure, Complications, Reoperations and Tips and Tricks

  • Selman UranuesEmail author
  • R. Latifi
Chapter
  • 1.2k Downloads

Abstract

Splenic surgery can be either diagnostic or therapeutic and can involve a partial or total resection of the organ. The main risk factors for perioperative complications are haematological disorders, use of anticoagulants and portal hypertension. The most common complication is bleeding, followed by postoperative pancreatitis. Abscesses develop mainly in the splenic fossa after a splenectomy. Infections are far more infrequent after partial resections. Intraoperative bleeding is due either to vascular injury during dissection of the hilum or to an accidental capsular lesion. The latter can be staunched with several minutes’ compression or simply with a haemostyptic.

Vascular bleeding can be a challenge, especially when it stems from a vein imbedded in fatty tissue. Even the most minor bleed should be coagulated or clipped immediately. Effective coagulation instruments such as the LigaSure® or ultrasonic shears can help to reduce bleeding complications.

Key elements for complication-free splenic surgery are knowledge of the surgical anatomy, as well as adherence to preventive measures and to the step-by-step dissection technique.

Keywords

Laparoscopic Splenectomy Splenic Vessel Postoperative Pancreatic Fistula Partial Splenectomy Trocar Placement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

334927_1_En_5_MOESM1_ESM.mp4 (290 mb)
Video 5.1 Chapter 6_uranues_video_1 (297, 000KB)
334927_1_En_5_MOESM2_ESM.mp4 (210.1 mb)
Video 5.2 Chapter 6_uranues_video_2 (215,124 KB)
334927_1_En_5_MOESM3_ESM.mov (85 mb)
Video 5.3 Chapter 6_uranues_video_3 (86,996 KB)
334927_1_En_5_MOESM4_ESM.mp4 (60.1 mb)
Video 5.1 Chapter 6_uranues_video_4 (61,521 KB)

Further Reading

  1. Targarona EM, Gracia E, Rodriguez M, Cerdan G, Balague C, Garriga J, Trias M (2003) Hand-assisted laparoscopic surgery. Arch Surg 138:133–141CrossRefPubMedGoogle Scholar
  2. Uranues S, Alimoglu O (2005) Laparoscopic surgery of the spleen. Surg Clin North Am 85(1):75–90, ix. ReviewCrossRefPubMedGoogle Scholar
  3. Uranues S, Grossman D, Ludwig L, Bergamaschi R (2007) Laparoscopic partial splenectomy. Surg Endosc 21(1):57–60, Epub 9 Oct 2006CrossRefPubMedGoogle Scholar
  4. Uranüs S, Pfeifer J, Schauer C, Kronberger L Jr, Rabl H, Ranftl G, Hauser H, Bahadori K (1995) Laparoscopic partial splenic resection. Surg Laparosc Endosc 5:133–136CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Section for Surgical ResearchDepartment of Surgery, Medical University of GrazGrazAustria
  2. 2.University of ArizonaArizonaUSA

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