[Laparoscopic splenectomy: first experiences with a 3-trocar-technique and the 'hanging-spleen-maneuver'].

Abstract:

AIMS:Laparoscopic splenectomy has been established as standard procedure for elective splenectomy and is performed for a variety of haematological diseases. However, different techniques have been used and a four- to five trocar technique is applied in most instances. We report our experience with a three-trocar technique using the triangular liver retractor and the so-called "hanging spleen" maneuver. METHODS:Data were obtained from a prospectively collected computer database of all patients who underwent elective laparoscopic splenectomy between April 2001 and July 2003. RESULTS:The study population consisted of 26 patients (14 men, 12 women, mean age: 45 years; range: 16-75 years). Median operative time was 140 min (85-310 min). There was one conversion (3.8 %) due to a suspected malignancy, which was finally not confirmed. A fourth trocar had to be placed in two cases (10 %) due to a large left lobe of the liver. In two patients a small midline incision was made to extract the spleen in toto for pathohistological examination due to a splenic metastasis. In the remaining cases the spleen was morcellated in an endobag. Accessory spleens were found in 1 patient (3.8 %). There were two bleedings following operation, which required laparotomy in one patient. There were no deaths (0 %). The median postoperative hospital stay was 7 days (range 3-17). CONCLUSIONS:Laparoscopic splenectomy can be performed safely in the vast majority of patients. The described technique using three trocars with the so-called "hanging spleen" maneuver can be used in about 90 % of cases.

journal_name

Zentralbl Chir

authors

Seelig MH,Senninger N,Kocher T

doi

10.1055/s-2004-820359

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

387-90

issue

5

eissn

0044-409X

issn

1438-9592

journal_volume

129

pub_type

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