Laparoscopic splenectomy. The suspended pedicle technique.
BACKGROUND
Elective splenectomy is often performed for hematological diseases, some of which cause only moderate enlargement of the spleen. The avoidance of an extensive upper abdominal incision is desirable in such cases and laparoscopic splenectomy offers significant potential advantages over the open operation if it can be performed safely and economically.


METHODS
Eight consecutive patients underwent laparoscopic splenectomy. The operation was carried out with the patient at 40 degrees in the right lateral position so that rotating the operating table would make a full right lateral position possible. After fenestration of the gastrocolic omentum and division of the short gastric vessels, this position allowed the spleen to be pushed up under the diaphragm to facilitate access to the splenic vessels and the hilum. Vessels were divided individually between clips.


RESULTS
All eight cases were completed laparoscopically. Mean length of operation was 259 min (range 230-285). Postoperative stay ranged from 2 to 7 days (median 4 days). There was no mortality, although minor complications did occur in three patients.


CONCLUSIONS
We found laparoscopic splenectomy to be a safe and feasible procedure for the elective removal of the moderately enlarged spleen.
Dexter
S P
SP
Leeds Institute for Minimally Invasive Therapy, General Infirmary, United Kingdom.
Martin
I G
IG
Alao
D
D
Norfolk
D R
DR
McMahon
M J
MJ
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000473:pathology / Q000601:surgery*