Laparoscopic treatment of blunt splenic injuries: initial experience with 11 patients

Abstract

Laparoscopy is a safe, feasible, and effective procedure for evaluation and treatment of hemodynamically stable patients with splenic injuries for whom nonoperative treatment is controversial.

Laparoscopic splenectomy for blunt trauma: a safe operation following embolization

“…The largest series was by Huscher from Italy, who reported on 11 cases of splenic injuries managed laparoscopically including six splenectomies and one partial splenectomy [13]. Nasr reported four cases, one for delayed hemorrhage for delayed hemorrhage following embolization [14].…”

Emergency Laparoscopic Splenectomy for Splenic Trauma in a Jehovah's Witness Patient

“…13,14 When doubt exist as to whether a hemodynamically stable patient with grades III or IV splenic injury or suspicion of associated enteric injuries should be managed nonoperatively or surgically, laparoscopy in experienced hands is a safe alternative to laparotomy as it allows for full exploration of the abdominal cavity, evacuation of hemoperitoneum with auto-transfusion, and spleen removal or repair. 17 The care for a Jehovah's Witness patient can be a challenge and often a dilemma to surgeons because of the patient's religious beliefs and teachings against receiving allogenic blood and blood products and components, especially in emergency or trauma settings. The ability to resuscitate these patients is therefore defective.…”

Use of fibrin glue (Tissucol) as a hemostatic in laparoscopic conservative treatment of spleen trauma

“…These factors include major politrauma, neurologic injury, high CT grades of injury (grade 3 or higher), active contrast extravasation on CT scan, hemoperitoneum exceeding 300 ml, and a drop in hemoglobin value [10]. Should the situation require surgery, spleen preservation should be attempted.…”