A novel spleen-preserving laparoscopic technique using radiofrequency ablation in a porcine model.
BACKGROUND
Partial splenectomy is considered to be the optimal management for a variety of diseases. At the same time, laparoscopic procedures are increasingly used because they present certain advantages against their open counterparts. In this study, the safety and efficacy of radiofrequency ablation (RFA) were evaluated in laparoscopic partial splenectomy performed in a pig model.


METHODS
Eight domestic pigs were used. Four abdominal trocars were inserted under general anesthesia and the spleen was stabilized with laparoscopic clamps. A RFA needle electrode was inserted transcutaneously, and coagulative necrosis of a zone of the splenic parenchyma between the body and the lower pole was performed. Bloodless sharp division and removal of the lower pole followed. After 0, 7, 30, or 120 days, the animals were killed and examined.


RESULTS
Blood loss and operation time were minimal. Mortality and morbidity were zero. No abnormal findings were encountered during the postmortem abdominal exploration.


CONCLUSIONS
This study demonstrates the feasibility, safety, and efficacy of laparoscopic RFA-assisted partial splenectomy. The RFA-assisted laparoscopic partial splenectomy adds a novel technique to the surgeon's armamentarium for the preservation of a part of the spleen.
Pikoulis
E
E
First Department of Surgery, University of Athens, Laiko General Hospital, 11527, Athens, Greece. mpikoul@med.uoa.gr
Felekouras
E
E
Papaconstantinou
I
I
Kontos
M
M
Prassas
E
E
Griniatsos
I
I
Bacoyiannis
C
C
Pappa
P
P
Papalois
A
A
Tsigris
C
C
Giannopoulos
A
A
Papalambros
E
E
Bramis
J
J
Bastounis
E
E
D000818:Animals; D017115:Catheter Ablation; D010535:Laparoscopy / Q000379:methods*; D023421:Models, Animal; D013156:Splenectomy / Q000379:methods*; D013552:Swine