Laparoscopic splenectomy using bipolar vessel sealing system

Abstract

Background: Newly developed vessels sealing device built upon bipolar diathermy technology had a greatimpact on facilitating advances laparoscopic surgery. Laparoscopic splenectomy is well established procedurebut in this study the procedure is totally based on bipolar vessel sealing system in devascularization of thespleen.Objective: To evaluate the safety of laparoscopic splenectomy with vessels sealing device and itsoutcome.Patient and method: Prospective study conducted in Baghdad Teaching Hospital and Dijlah private hospitalfrom October 2009 to October 2013. Thirty patients with idiopathic thrombocytopenic purpura(ITP) wereincluded and had laparoscopic splenectomy . The adapted procedure was stapleless laproscopic splenectomy,without clips using vessels sealing device only.Result: A total of 30 patients were recruited. The mean of their ages was 25.2 years. Eleven of them weremales and 19 were females. The mean operative time was 84.3 min. The mean estimated blood loss was 105ml. Twenty seven spleens were extracted through small Pfannenstiel incision and 3 spleens were retrievedby retrieval bag. No conversion had occurred; the mean hospital stay was 2.3 days. Neither bleeding norany other serious complication related to this technique were observed, only one patient complicated bycollection which was treated by aspiration under ultrasound guide. No mortalities were recorded.Conclusion: Laparoscopic splenectomy of normal size and mildly enlarged spleen with use of vessels sealing device without staple or clips is safe and effective.