Abstract
We describe the clinical course of 23 patients considered for laparoscopic splenectomy. One patient was excluded on the basis of preoperative angiography findings, and two (9%) were converted to open surgery. In the remaining 20 patients who successfully underwent laparoscopic splenectomy, no mortality was reported; four postoperative complications (20% morbidity) occurred. Mean operating time was 3 h 35 min (135–300 min). After a mean postoperative stay of 3.9 days (2–9 days), all patients except two were back to normal activities within 2 weeks of hospital discharge. Preoperative splenic artery embolization, begun with the third patient, helped to reduce operative blood loss and made the procedure easier to perform. Laparoscopic splenectomy has become our procedure of choice for elective removal of normalsized (<11 cm long) or moderately enlarged (11–20 cm long) spleens.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Ballinger WF, Erslev AJ (1965) Splenectomy: indications, technique and complications. Curr Probl Surg Feb: 1–51
Baronofsky ID, Walton W, Noble JF (1951) Occult injury to the pancreas following splenectomy. Surgery 29: 852–856
Carroll BJ, Phillips EH, Semel CJ, Fallas M, Morgenstern L (1992) Laparoscopic splenectomy. Surg Endosc 6: 183–185
Castaneda Zuniga WR, Hammerschmidt DE, Sanchez R, Amplatz K (1977) Nonsurgical splenectomy. AJR 129: 805–811
Delaitre B, Maignen B (1991) Splénectomie par voie laparoscopique, 1 observation. Presse Med 20: 2263
Fujitani RM, Johs SM, Cobb SR, Mehrenger CM, White RA, Klein SR (1991) Preoperative splenic artery occlusion as an adjunct for high risk splenectomy. Am Surg 54: 602–608
Goldstone J (1978) Splenectomy for massive splenomegaly. Am J Surg 135: 385–388
Goerg C, Schwerk WB, Goerg K, Havemann K (1990) Sonographic patterns of the affected spleen in malignant lymphoma. J Clin Ultrasound 18: 569–574
Hiatt JR, Gomes AS, Machleder HI (1990) Massive splenomegaly. Superior results with a combined endovascular and operative approach. Arch Surg 125: 1363–1367
Hilleren DJ (1991) Embolization of the spleen for the treatment of hypersplenism and in portal hypertension. In: Kadir S (ed) Current practice of interventional radiology, spleen, pp 494–497 Philadelphia, BC Decker
Hoeffer RA, Scullin DC, Silver LF, Weakly SD (1991) Splenectomy for hematologic disorders: a 20 year experience. J Ky Med Assoc 89: 446–449
Litwin DEM, Girotti MJ, Poulin EC, Mamazza J, Nagy AG (1992) Laparoscopic cholecystectomy: trans-Canada experience with 2201 cases. Can J Surg 35: 291–296
Ly B, Albrechtson D (1981) Therapeutic splenectomy in hematologic disorders. Effects and complications in 221 adult patients. Acta Med Scand 209: 21–29
Macrae HM, Yakimets WW, Reynolds T (1992) Perioperative complications of splenectomy for hematologic disease. Can J Surg 35: 432–436
Malmaeus J, Akre T, Adami Ho (1986) Early postoperative course following elective splenectomy in hematological disease: a high complication rate in patients with myeloproliferative disorders. Br J Surg 73: 720–723
Merlier O, Ribet M, Mensier E, Ronsmans N, Caulier MT (1992) Role of accessory spleen in recurrent hematologic diseases. Chirurgie 118: 229–235
Michels NA (1942) The variational anatomy of the spleen and splenic artery. Am J Anat 70: 21–72
Perry JF Jr (1984) Anatomy of the spleen, splenectomy and excision of accessory spleens. In Nyhus LM, Baker RJ (eds) Mastery of surgery. Little, Brown and Company, Boston pp 823–829
Poulin EC, Thibault C (1993) The anatomical basis for laparoscopic splenectomy. Can J Surg 36: 485–488
Poulin E, Thibault C, Mamazza J, Girotti M, Côté G, Renaud A (1993) Laparoscopic splenectomy: clinical experience and the role of preoperative splenic artery embolization. Surg Laparosc Endosc 3: 445–450
Sheldon GF, Croom RD, Meyer AA (1991) The Spleen. In: Sabiston DC (ed) Textbook of surgery, 14th ed. WB Saunders Company, Philadelphia, pp 1108–1133
Thibault C, Mamazza J, Létourneau R, Poulin E (1992) Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc 2: 248–253
Ziemski JM, Rudowski WJ, Jaskowiak W (1987) Evaluation of early postsplenectomy complications. Surg Gynecol Obstet 165: 597–614
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Poulin, E.C., Thibault, C. & Mamazza, J. Laparoscopic splenectomy. Surg Endosc 9, 172–177 (1995). https://doi.org/10.1007/BF00191961
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00191961