Hand-assisted laparoscopic splenectomy for giant spleens.
BACKGROUND
Laparoscopic splenectomy for massive splenomegaly is technically difficult, and the morcellated splenic tissue may be inadequate for histologic study. A hand-assisted technique may provide a technical advantage and allow removal of larger pieces of spleen.


METHODS
Patients who underwent hand-assisted laparoscopic splenectomy for massive splenomegaly were reviewed. Demographic information, operative data, and outcomes data were tabulated.


RESULTS
Sixteen patients met these criteria. Mean age was 56 years (range, 35-78 years). Operating time averaged 240 min (range, 165-360 min), and median blood loss was 425 cc (range, 100-1800 cc). There were no conversions to an open procedure. Mean weight of extracted spleens was 2008 g (range, 543-4090 g). Postoperative length of stay averaged 3.3 days (range, 2-7 days). There was one postoperative complication (6.25%) and no mortality.


CONCLUSIONS
Hand-assisted laparoscopic splenectomy for massive splenomegaly is feasible and safe while preserving the recovery benefits of minimal access surgery. It provides an adequate specimen for histologic study.
Borrazzo
E C
EC
Department of Surgery, Weill Medical College of Cornell University, 525 E. 68th Street, New York, NY 10021, USA.
Daly
J M
JM
Morrisey
K P
KP
Fischer
E
E
Belmont
M
M
Hogle
N J
NJ
Fowler
D L
DL
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001810:Blood Volume; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D013154:Spleen / Q000473:pathology / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly / Q000601:surgery*; D013997:Time Factors