Laparoscopic splenectomy

Abstract

Splenectomy has traditionally been done through a generous laparotomy incision, requiring complete mobilization of the spleen for removal. In selected cases, however, splenectomy may either be facilitated or performed entirely by laparoscopic means. Two patients with Hodgkin's disease in whom splenectomy was facilitated laparoscopically are described; in another patient with idiopathic thrombocytopenic purpura (ITP), the splenectomy was successfully performed through the trocar incisions. In selected cases, laparoscopic splenectomy is feasible, provided the laparoscopist is expert in advanced techniques of intraabdominal endoscopic surgery.

Minimally invasive splenectomy: an update and review

“…Subcutaneous heparin injections and compression stockings should be used as deep vein thrombosis prophylaxis. A Foley catheter and a nasogastric tube can also be used, 2,3,7,11 but are typically not necessary. There has been debate over whether imaging for accessory spleens is necessary.…”

“…2,3,[5][6][7]11,16 Most authors report lower operative blood loss with LS. Postoperative splenectomy complications, such as pneumonia and atelectasis, were less frequent with LS than OS.…”

“…Subsequent literature has shown that minimally invasive splenectomy improves patient morbidity, reduces length of stay in hospital, reduces perioperative pain and provides enhanced cosmesis. [2][3][4][5][6] The breadth of minimally invasive splenectomy procedures now includes handassisted LS (HALS), natural orifice transluminal endoscopic surgery (NOTES), robot-assisted splenectomy and single-port access (SPA) splenectomy. [7][8][9][10][11][12][13][14][15] Currently, minimally invasive splenectomy is successfully performed for a variety of conditions, including idiopathic thrombocytopenic purpura, hereditary spherocytosis, autoimmune hemolytic anemia, thrombocytopenic purpura, Hodgkin and non-Hodgkin lymphoma, chronic lymphocytic leukemia, hemangiomas, idiopathic myelofibrosis, myelodysplastic syndrome, hairy cell leukemia, splenic abscess or cyst, and tuberculosis.…”

Laparoscopic partial and total splenectomy in non-trauma patients

“…In 1991, only four years after the beginning of the laparoscopic era, Delaitre [4] reported the first laparoscopic splenectomy. With rapid developments in instruments and imaging systems, laparoscopy gained popularity for spleen surgery, [5,6] and today, laparoscopic splenectomy is nothing unusual. In some indications, laparoscopy is on its way to becoming standard, though splenectomy in trauma cases remains within the domain of conventional open surgery.…”

Preference of Laparoscopic Splenectomy over Steroid Therapy in a Young Field Athlete with Immune Thrombocytopenic Purpura.

“…Eventhough the success ratio of the splenectomyis equal to that of steroid therapy (1), and splenectomy (2), including that by the laparoscopic method (3,4) has recently been reported to be effective, splenectomy is not generally selected as the first choice of therapy for immunethrombocytopenic purpura. On October 16, 1995, we performed a laparoscopic splenectomy in preference to steroid therapy on a 15-year-old male field athlete with immunethrombocytopenic purpura.…”