Abstract
Background
Partial splenectomy is considered to be the optimal management for a variety of diseases. At the same time, laparoscopic procedures are increasingly used because they present certain advantages against their open counterparts. In this study, the safety and efficacy of radiofrequency ablation (RFA) were evaluated in laparoscopic partial splenectomy performed in a pig model.
Methods
Eight domestic pigs were used. Four abdominal trocars were inserted under general anesthesia and the spleen was stabilized with laparoscopic clamps. A RFA needle electrode was inserted transcutaneously, and coagulative necrosis of a zone of the splenic parenchyma between the body and the lower pole was performed. Bloodless sharp division and removal of the lower pole followed. After 0, 7, 30, or 120 days, the animals were killed and examined.
Results
Blood loss and operation time were minimal. Mortality and morbidity were zero. No abnormal findings were encountered during the postmortem abdominal exploration.
Conclusion
This study demonstrates the feasibility, safety, and efficacy of laparoscopic RFA-assisted partial splenectomy. The RFA-assisted laparoscopic partial splenectomy adds a novel technique to the surgeon’s armamentarium for the preservation of a part of the spleen.
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References
Atmatzidis K, Papaziogas B, Mirelis C, Pavlidis T, Papaziogas T (2003) Splenectomy versus spleen preserving surgery for splenic echinococcosis Dig Surg 20: 527–531
Corcione F, Cuccurallo D, Caiazzo P, Settembre A, Bruzzese G, Vittoria I, Cusano T (2003) Laparoscopic partial splenectomy for a splenic pseudocyst Surg Endosc 17: 1850
Felekouras E, Kontos M, Pissanou T, et al (2004) Radio-frequency tissue ablation in liver trauma: an experimental study Am Surg 70: 989–993
Felekouras E, Kontos M, Pissanou T, Pikoulis E, Drakos E, Papalambros E, Diamantis T, Bastounis E (2004) A new spleen preserving technique using radiofrequency ablation technology J Trauma 57: 1225–1229
Habib NA, Spalding D, Navarra G, Nicholls J (2003) How we do a bloodless partial splenectomy Am J Surg 186: 164–106
Ho CM, (2002) Splenic cysts: a new approach to partial splenectomy Surg Endosc 16: 717
Kaiwa Y, Kurokawa Y, Namini K, Matsumoto H, Satomi S (2000) Laparoscopic partial splenectomies for true splenic cysts. A report of two cases Surg Endosc 14: 865
Kontos M, Felekouras E, Drakos E, et al (2005) Radio-frequency tissue ablation in an experimental grade IV renal trauma: a preliminary report. Surg Endosc 19: 249–253. Epub 2004 Nov 11
Lupo L, Gallerani A, Aquilino F, Di Palma G, De Fazio M, Guglielmi A, Memeo V (2003) Anatomical hepatic relation using radiofrequency thermoablation in the treatment of primary or secondary liver tumors Tumori 89(suppl): 105–106
Morgenstern L, Verham R, Weinstein I, Phillips EH (1993) Subtotal splenectomy for Gaucher’s disease: a follow-up study Am Surg 59: 860–865
Pampaloni F, Valeri A, Mattel R, Presenti L, Noccioli B, Tozzini S, Di Lollo S, Pampaloni A (2002) Laparoscopic decapsulation of a large epidermoid splenic cyst in a child using the UltraCisio LaparoSonic Coagulating Shears Pediatr Med Chir 24: 59–62
Peitzman AB, Ford HR, Harbrecht BG, Potoka DA, Townsend RN (2001) Injury to the spleen Curr Probl Surg 38: 921–1008
Rice HE, Oldham KT, Hillery CA, Skinner MA, O’Hara SM, Ware RE (2003) Clinical and hematologic benefits of partial splenectomy for congenital hemolytic anemias in children Ann Surg 237: 281–288
Seshadri PA, Poulin EC, Mamazza J, Schlachta CM (2000) Technique for laparoscopic partial splenectomy Surg Laparosc Endosc Percutan Tech 10: 106–109
Solbiati L, Goldberg SN, Ierace T, Livraghi T, Meloni F, Dellanoce M, Sironi S, Gazelle GS (1997) Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes Radiology 205: 367–373
Thalhammer GH, Eber E, Uranus S, Pfeifer J, Zach MS (2003) Partial splenectomy in cystic fibrosis patients with hypersplenism Arch Dis Child 88: 143–146
Uranus S, Kronberger L, Kraft-Kine J (1994) Partial splenic resection using the TA-stapler Am J Surg 168: 49–53
Van der Zee DC, Kramer WL, Ure BM, Mokhaberi B, Bax NM (1999) Laparoscopic management of a large posttraumatic splenic cyst in a child Surg Endosc 13: 1241–1242
Velanovich V, Weaver M (2003) Partial splenectomy using a coupled saline–radiofrequency hemostatic device Am J Surg 185: 66–68
Weber JC, Navarra G, Habib NA, Bachellier P, Jaeck D (2003) Laparoscopic radiofrequency-assisted liver resection. Surg Endosc 17: 834
Weber JC, Navarra G, Jiao LR, Nicholls JP, Jensen SL, Habib NA (2002) New technique for liver resection using heat coagulative necrosis Ann Surg 236: 560–563
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Pikoulis, E., Felekouras, E., Papaconstantinou, I. et al. A novel spleen-preserving laparoscopic technique using radiofrequency ablation in a porcine model. Surg Endosc 19, 1329–1332 (2005). https://doi.org/10.1007/s00464-004-2219-y
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DOI: https://doi.org/10.1007/s00464-004-2219-y