Splenic artery aneurysms: methods of laparoscopic repair.
OBJECTIVE
Surgical therapy for splenic artery aneurysms (SAAs) has traditionally consisted of a laparotomy with resection of the aneurysm and possibly a splenectomy. Our early experience with the laparoscopic approach to treat SAAs is reported.


METHODS
A retrospective review of medical records was conducted on all patients who underwent laparoscopic resection of SAAs at the Cleveland Clinic Foundation from May 1996 to August 1997.


RESULTS
Four patients with SAAs, three women and one man, with an average age of 55 years (range, 37 to 63 years), underwent successful laparoscopic SAA repair. The average size of the aneurysm was 3.2 cm (range, 2.5 to 5.0 cm). Three patients underwent an aneurysm resection, whereas one patient underwent simple ligation. Intraoperative ultrasound scanning with Doppler was used in three cases as a means of localizing the aneurysm and identifying all feeding vessels; the complete cessation of flow within the aneurysm in the case in which the feeding vessels were simply ligated was also documented. The average intraoperative time was 150 minutes (range, 100 to 190 minutes). The mean estimated blood loss was 105 mL (range, 20 to 300 mL). There were no intraoperative complications. The average hospital stay was 2.2 days (range, 1 to 4 days).


CONCLUSIONS
The laparoscopic approach to splenic artery aneurysm by aneurysmectomy or splenic artery ligation can be safe and effective. The laparoscopic approach affords a short hospital stay and an effective result.
Departments of General and Vascular Surgery, The Cleveland Clinic Foundation, and the Department of Laparoscopic Surgery, Mount Sinai Medical Center, New York, NY, USA.
M J
MJ
Arca
M
M
Gagner
B T
BT
Heniford
T M
TM
Sullivan
E G
EG
Beven
D000783:Aneurysm / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods; D013157:Splenic Artery / Q000601:surgery; D013997:Time Factors