Laparoscopic splenectomy: A report of 32 cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the feasibility of laparoscopic splenectomy(LS).Methods Laparoscopic splenectomy was performed in 32 cases from June 1999 to December 2005 in this hospital.The splenic ligaments were disconnected using a harmonic scalpel and the pedicle of spleen was cut using the Endo-GIA system.After the spleen was mobilized,it was placed into an extraction bag,broken into small pieces,and removed from the extraction incision.Results The operation was successfully completed in 29 cases.The operation time was 60~270 min(mean,100 min),the amount of intraoperative blood loss was 30~1 000 ml(mean,230 ml),and the length of postoperative hospital stay,3~7 d(mean,5 d).No postoperative complications occurred.Conversions to open surgery were needed in 3 cases because of hemorrhage of the splenic pedicle,hemorrhage of the short gastric vessels,and extensive adhesion,respectively.Of the 22 cases of idiopathic thrombocytopenic purpura(ITP),the platelet count recovered to normal levels in 18 cases and kept unchanged in 4 cases.Of the 2 cases of hemolytic anemia,the hemoglobin levels were elevated after operation.Of the 4 cases of hypersplenism accompanying posthepatitic cirrhosis,the platelet count recovered to normal levels.Conclusions Laparoscopic splenectomy is a safe and feasible,especially for patients with hematologic diseases.