The technique of laparoscopic retroperitoneal splenopexy for symptomatic wandering spleen in childhood.
BACKGROUND
Wandering spleen is an uncommon diagnosis, difficult to prove by standard investigations. The authors report a new method for laparoscopic splenopexy in children using a balloon-dilated retroperitoneal pouch.


METHODS
From 3 accesses, the spleen is mobilized and displaced into a retroperitoneal pouch dilated to the double splenic volume. The pouch is dilated by a self-made balloon via a further intercostal access and narrowed by sutures incorporating the cranial and caudal edge of the gastrosplenic ligament.


RESULTS
The peritoneal pouch contracts around the retroperitoneal spleen resulting in a firm fixation of the organ. This technique was successful in a 9-year-old girl with a 5-year history of severe recurrent abdominal pain.


CONCLUSIONS
Laparoscopic retroperitoneal pouch splenopexy is a safe and effective procedure for symptomatic wandering spleen precluding the use of foreign materials in this age group.
Schaarschmidt
Klaus
K
Helios-Center for Pediatric Surgery, Klinikum Buch, D-13125 Berlin, Germany. kschaarschmidt@klinikumbuch.de
Lempe
Michael
M
Kolberg-Schwerdt
Andreas
A
Schlesinger
Frank
F
Hayek
Irina
I
Jaeschke
Uwe
U
D015746:Abdominal Pain / Q000209:etiology; D000855:Anorexia / Q000209:etiology; D002404:Catheterization; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008022:Ligaments / Q000601:surgery; D010537:Peritoneum / Q000601:surgery; D011187:Posture; D012008:Recurrence; D012187:Retroperitoneal Space; D050805:Wandering Spleen / Q000150:complications / Q000175:diagnosis / Q000601:surgery*