Simple method of laparoscopic splenectomy |
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Authors: | Masaji Hashimoto Masamichi Matsuda Goro Watanabe |
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Institution: | (1) Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan |
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Abstract: | 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).
Conclusion 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. |
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Keywords: | Laparoscopic splenectomy Cherry dissector Gastrosplenic ligament Stapling method |
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