title: Use of Nathanson retractor during laparoscopic splenectomy for supermassive spleens.
abstract: BACKGROUND
  Although feasibility of laparoscopic splenectomy for supermassive spleens has been described, obtaining uniform and uninterrupted retraction of a heavy spleen to ensure safe hilar dissection is challenging. We describe a technique of retraction of supermassive spleens using a Nathanson retractor.
  
  
  METHODS
  This technique was used in 4 patients, and the demographic data as well as data related to the surgery were retrospectively collected.
  
  
  RESULTS
  The spleens weighed between 2.5 and 3.5 kg. The median operative time was 190 minutes (155-220 min) and the median intraoperative blood loss was 870 mL (600-1230 mL). The postoperative hospital stay ranged from 3 to 5 days.
  
  
  CONCLUSIONS
  A Nathanson retractor provides sustained retraction of a supermassive spleen during laparoscopic splenectomy and this technique should be considered a useful adjunct to the armamentarium of surgeons undertaking these challenging procedures.
authors: Department of Minimal Access Surgery, Hinduja Hospital, Veer Savarkar Marg, Mahim, Mumbai, India. deeprajbhandarkar@hotmail.com
authors: Deepraj
authors: D
authors: Bhandarkar
authors: Avinash
authors: A
authors: Katara
authors: Gaurav
authors: G
authors: Mittal
authors: Tehemton E
authors: TE
authors: Udwadia
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013156:Splenectomy / Q000295:instrumentation*; D013163:Splenomegaly / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome