Partial laparoscopic splenectomy for trauma: technique and case report.
We describe the course of a patient who underwent partial laparoscopic splenectomy after a fall while skiing. Computed tomography revealed intact liver and kidneys with fragmentation of the upper third of the spleen and a left upper quadrant hematoma. Splenic artery angiogram showed devascularization of the superior pole, and selective cannulation of the superior polar artery demonstrated extravasation of contrast media. The superior polar artery was embolized with three coils to control bleeding. After laparoscopic exploration, the patient underwent partial laparoscopic splenectomy of the superior pole, which consisted of ligating the short gastric vessels and incising the splenic parenchyma 6 to 8 mm above the ischemic demarcation line produced by embolization of the superior polar artery, where a deep transverse laceration was located. The specimen was retrieved in a plastic bag. Intraoperative blood loss was less than 50 ml, and the patient left the hospital on the 3rd postoperative day after an uneventful recovery. Partial laparoscopic splenectomy can be performed safely, and its role needs to be delineated.
Poulin
E C
EC
Department of Surgery, Hôpital du Saint-Sacrement, Université Laval, Québec, Canada.
Thibault
C
C
DesCôteaux
J G
JG
Côté
G
G
D000293:Adolescent; D016063:Blood Loss, Surgical; D001810:Blood Volume; D004621:Embolization, Therapeutic; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011859:Radiography; D012865:Skiing / Q000293:injuries*; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy / Q000379:methods*; D013157:Splenic Artery / Q000000981:diagnostic imaging