Elective laparoscopic splenectomy for grade III splenic injury in an athlete.
The safety and efficacy of laparoscopic splenectomy in the management of benign hematologic diseases is well established. Laparoscopic splenectomy for splenic trauma has been reported infrequently, and most consider a minimally invasive approach to be contraindicated. A heralded, standout college football player who sustained a grade III splenic laceration while playing football was referred for laparoscopic splenectomy so that he could convalesce rapidly, complete his final year of athletic eligibility, and prepare for the National Football League draft. The ethical issues regarding this patient's care were discussed extensively with the patient, his parents, and the hospital administration. After informed consent, the patient underwent a laparoscopic splenectomy with no intraoperative complications. He was discharged 20 hours after surgery. The patient played in a collegiate football game 12 days after surgery, was drafted into the National Football League 9 months later, and was on the opening day roster 12 months after his surgery. We do not advocate laparoscopic splenectomy for injuries to the spleen as the standard of care. This case, however, illustrates the potential for laparoscopic surgery to provide a safe and feasible alternative to traditional surgical approaches.
Department of Surgery, Carolinas Medical Center, Medical Education Building Suite 601, 1000 Blythe Boulevard, Charlotte, NC 28203, USA.
Gamal
G
Mostafa
Brent D
BD
Matthews
Ronald F
RF
Sing
Dalton
D
Prickett
B Todd
BT
Heniford
D000328:Adult; D003657:Decision Making; D017558:Elective Surgical Procedures; D004992:Ethics, Medical; D005538:Football / Q000293:injuries*; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy / Q000379:methods*