Laparoscopic splenectomy using conventional instruments

• Main Authors: Dalvi A, Thapar P, Deshpande A, Rege S, Prabhu R, Supe A, Kamble R
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2005-01-01
• Series: Journal of Minimal Access Surgery
• Subjects: Laparoscopy; minimal access surgery; splenectomy
• Online Access: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2005;volume=1;issue=2;spage=63;epage=69;aulast=Dalvi

<b>INTRODUCTION</b> : Laparoscopic splenectomy (LS) is an accepted procedure for elective splenectomy. Advancement in technology has extended the possibility of LS in massive splenomegaly [Choy et al., J Laparoendosc Adv Surg Tech A 14(4), 197-200 (2004)], trauma [Ren et al., Surg Endosc 15(3), 324 (2001); Mostafa et al., Surg Laparosc Endosc Percutan Tech 12(4), 283-286 (2002)], and cirrhosis with portal hypertension [Hashizume et al., Hepatogastroenterology 49(45), 847-852 (2002)]. In a developing country, these advanced gadgets may not be always available. We performed LS using conventional and reusable instruments in a public teaching the hospital without the use of the advanced technology. The technique of LS and the outcome in these patients is reported. <b> MATERIALS AND METHODS</b> : Patients undergoing LS for various hematological disorders from 1998 to 2004 were included. Electrocoagulation, clips, and intracorporeal knotting were the techniques used for tackling short-gastric vessels and splenic pedicle. Specimen was delivered through a Pfannensteil incision. <b> RESULTS</b> : A total of 26 patients underwent LS. Twenty-two (85&#x0025;)<b> </b> of patients had spleen size more than 500 g (average weight being 942.55 g). Mean operative time was 214 min (45-390 min). The conversion rate was 11.5&#x0025; (<i> n</i> = 3). Average duration of stay was 5.65 days (3-30 days). Accessory spleen was detected and successfully removed in two patients. One patient developed subphrenic abscess. There was no mortality. There was no recurrence of hematological disease. <b> CONCLUSION</b> : Laparoscopic splenectomy using conventional equipment and instruments is safe and effective. Advanced technology has a definite advantage but is not a deterrent to the practice of LS.