title: A laparoscopic approach to partial splenectomy for children with hereditary spherocytosis.
abstract: BACKGROUND
  Partial splenectomy is sometimes used for children with hereditary spherocytosis (HS) to reduce hemolysis while retaining some splenic immune function. Previous reports have described a partial splenic resection through a laparotomy incision. Whereas laparoscopic total splenectomy for HS is well-established, laparoscopic partial splenectomy (LPS) has not been described. The authors have developed a novel LPS technique that combines the benefits of partial splenectomy with those of a laparoscopic approach.
  
  
  METHODS
  A chart review was conducted for three children with HS who underwent LPS, with approximately one-fourth of the spleen left on the basis of the short gastric arterial supply.
  
  
  RESULTS
  The mean preoperative spleen size was 17.6 cm. The mean preoperative hemoglobin count was 100 g/l, and the postoperative hemoglobin count was 133 g/l. All three patients reported reduced malaise and increased energy levels. There was no recurrent anemia at the 1- to 2-year follow-up evaluation.
  
  
  CONCLUSIONS
  The LPS procedure is a safe and effective approach to HS that resolves anemia, potentially retains some splenic immunity, and confers the benefits of a minimal access technique.
authors.affiliation: Division of Pediatric Surgery, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Dutta
authors.forename: V E
authors.initials: VE
authors.lastname: Price
authors.forename: V
authors.initials: V
authors.lastname: Blanchette
authors.forename: J C
authors.initials: JC
authors.lastname: Langer
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D010535:Laparoscopy; D008297:Male; D013103:Spherocytosis, Hereditary / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*