Laparoscopic splenectomy using conventional instruments

Laparoscopic splenectomy using conventional instruments

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INTRODUCTION : Laparoscopic splenectomy (LS) is an accepted procedure for elective splenectomy.Advancement in technology has extended the possibility of LS in massive splenomegaly [Choy et al., J Laparoendosc Adv Surg Tech A 14(4), 197-200 (2004)], trauma [Ren et al., Surg Endosc 15(3), 324 (2001); Mostafa et al.

, Surg Laparosc Endosc Percutan Tech 12(4), 283-286 (2002)], and cirrhosis with portal hypertension [Hashizume et al., Hepatogastroenterology 49(45), 847-852 (2002)].In a developing country, these advanced gadgets may ADVANCED B COMPLEX not be always available.We performed LS using conventional and reusable instruments in a public teaching the hospital without the use of the advanced technology.

The technique of LS and the outcome in these patients is reported.MATERIALS AND METHODS : Patients undergoing LS for various hematological disorders from 1998 to 2004 were 110 included.Electrocoagulation, clips, and intracorporeal knotting were the techniques used for tackling short-gastric vessels and splenic pedicle.Specimen was delivered through a Pfannensteil incision.

RESULTS : A total of 26 patients underwent LS.Twenty-two (85%) of patients had spleen size more than 500 g (average weight being 942.55 g).Mean operative time was 214 min (45-390 min).

The conversion rate was 11.5% ( n = 3).Average duration of stay was 5.65 days (3-30 days).

Accessory spleen was detected and successfully removed in two patients.One patient developed subphrenic abscess.There was no mortality.There was no recurrence of hematological disease.

CONCLUSION : Laparoscopic splenectomy using conventional equipment and instruments is safe and effective.Advanced technology has a definite advantage but is not a deterrent to the practice of LS.