Simple method of laparoscopic splenectomy.
BACKGROUND
Although laparoscopic splenectomy was introduced in 1991, it has not become a standard procedure for splenectomy like laparoscopic cholecystectomy for gallstone disease. The reasons for this may include difficulty in grasping the spleen and difficulty with controlling hemorrhage. Here we present a simple method of laparoscopic splenectomy.


METHODS
We performed laparoscopic splenectomy in 46 patients from 1994 to 2006. Our procedure had four main features: (1) adoption of a lateral position so that gravity assists with the spleen, (2) exposure of the operative field using two cherry dissectors, (3) only dividing the upper part of the gastrosplenic ligament, and (4) stapling the splenic hilus together with the lower part of the gastrosplenic ligament.


RESULTS
Among 46 patients undergoing laparoscopic splenectomy, none of them were converted to open splenectomy. Three patients had postoperative intraperitoneal bleeding from the stapled stump of the splenic artery. In 28 patients during the most recent 3 years, the mean operating time was 71 min and only one patient had postoperative bleeding (hemostasis was achieved laparoscopically).


CONCLUSIONS
Exposure of the operating field using cherry dissector and stapling of the splenic hilus together with the lower part of the gastrosplenic ligament are key points of our method of laparoscopic splenectomy.
Hashimoto
Masaji
M
Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. masajih-ind@umin.ac.jp
Matsuda
Masamichi
M
Watanabe
Goro
G
D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D011187:Posture / Q000502:physiology; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*; D016896:Treatment Outcome