Abstract
Background: Elective splenectomy is often performed for hematological diseases, some of which cause only moderate enlargement of the spleen. The avoidance of an extensive upper abdominal incision is desirable in such cases and laparoscopic splenectomy offers significant potential advantages over the open operation if it can be performed safely and economically.
Methods: Eight consecutive patients underwent laparoscopic splenectomy. The operation was carried out with the patient at 40° in the right lateral position so that rotating the operating table would make a full right lateral position possible. After fenestration of the gastrocolic omentum and division of the short gastric vessels, this position allowed the spleen to be pushed up under the diaphragm to facilitate access to the splenic vessels and the hilum. Vessels were divided individually between clips.
Results: All eight cases were completed laparoscopically. Mean length of operation was 259 min (range 230–285). Postoperative stay ranged from 2 to 7 days (median 4 days). There was no mortality, although minor complications did occur in three patients.
Conclusions: We found laparoscopic splenectomy to be a safe and feasible procedure for the elective removal of the moderately enlarged spleen.
Similar content being viewed by others
References
Carroll BJ, Phillips EH, Semel CJ, Fallas M, Morgenstern L (1992) Laparoscopic splenectomy. Surg Endosc 6: 183–185
Cuschieri A, Shimi S, Banting S, Vander Velpen G (1992) Technical aspects of laparoscopic splenectomy: hilar segmental devascularisation and instrumentation. J R Coll Surg Edinb 37: 414–416
Delaitre B, Maignien B, Icard P (1992) Laparoscopic splenectomy. Br J Surg 79: 1334
Gigot JF, Healy ML, Ferrant A, Michaux JC, Nisinov B, Kestons PJ (1994) Laparoscopic splenectomy for idiopathic thrombocytopaenic purpura. Br J Surg 81: 1171–1172
Hiatt JR, Gomes AS, Machleder HI (1990) Massive splenomegaly. Superior results with a combined endovascular and operative approach. Arch Surg 125: 1363–1367
Macrae H, Yakimets WW, Reynolds T (1992) Perioperative complications of splenectomy for haematological disease. Can J Surg 35: 432–436
Malmaeus J, Akra T, Adami HO, Hagberg H (1986) Early postoperative course following elective splenectomy in haematological diseases: a high complication rate in patients with myeloproliferative disorders. Br J Surg 73: 720–723
Poulin E, Thibault C, Mamazza J, Girotti M, Cote G, Ronaud A (1993) Laparoscopic splenectomy: clinical experience and the role of preoperative splenic artery embolisation. Surg Laparosc Endosc 3: 445–450
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dexter, S.P.L., Martin, I.G., Alao, D. et al. Laparoscopic splenectomy. Surg Endosc 10, 393–396 (1996). https://doi.org/10.1007/BF00191622
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00191622