Skip to main content
Top
Published in: Surgical Endoscopy 10/2005

01-10-2005 | Original

A novel spleen-preserving laparoscopic technique using radiofrequency ablation in a porcine model

Authors: E. Pikoulis, E. Felekouras, I. Papaconstantinou, M. Kontos, E. Prassas, I. Griniatsos, C. Bacoyiannis, P. Pappa, A. Papalois, C. Tsigris, A. Giannopoulos, E. Papalambros, J. Bramis, E. Bastounis

Published in: Surgical Endoscopy | Issue 10/2005

Login to get access

Abstract

Background

Partial splenectomy is considered to be the optimal management for a variety of diseases. At the same time, laparoscopic procedures are increasingly used because they present certain advantages against their open counterparts. In this study, the safety and efficacy of radiofrequency ablation (RFA) were evaluated in laparoscopic partial splenectomy performed in a pig model.

Methods

Eight domestic pigs were used. Four abdominal trocars were inserted under general anesthesia and the spleen was stabilized with laparoscopic clamps. A RFA needle electrode was inserted transcutaneously, and coagulative necrosis of a zone of the splenic parenchyma between the body and the lower pole was performed. Bloodless sharp division and removal of the lower pole followed. After 0, 7, 30, or 120 days, the animals were killed and examined.

Results

Blood loss and operation time were minimal. Mortality and morbidity were zero. No abnormal findings were encountered during the postmortem abdominal exploration.

Conclusion

This study demonstrates the feasibility, safety, and efficacy of laparoscopic RFA-assisted partial splenectomy. The RFA-assisted laparoscopic partial splenectomy adds a novel technique to the surgeon’s armamentarium for the preservation of a part of the spleen.
Literature
1.
go back to reference Atmatzidis K, Papaziogas B, Mirelis C, Pavlidis T, Papaziogas T (2003) Splenectomy versus spleen preserving surgery for splenic echinococcosis Dig Surg 20: 527–531CrossRefPubMed Atmatzidis K, Papaziogas B, Mirelis C, Pavlidis T, Papaziogas T (2003) Splenectomy versus spleen preserving surgery for splenic echinococcosis Dig Surg 20: 527–531CrossRefPubMed
2.
go back to reference Corcione F, Cuccurallo D, Caiazzo P, Settembre A, Bruzzese G, Vittoria I, Cusano T (2003) Laparoscopic partial splenectomy for a splenic pseudocyst Surg Endosc 17: 1850 Corcione F, Cuccurallo D, Caiazzo P, Settembre A, Bruzzese G, Vittoria I, Cusano T (2003) Laparoscopic partial splenectomy for a splenic pseudocyst Surg Endosc 17: 1850
3.
go back to reference Felekouras E, Kontos M, Pissanou T, et al (2004) Radio-frequency tissue ablation in liver trauma: an experimental study Am Surg 70: 989–993PubMed Felekouras E, Kontos M, Pissanou T, et al (2004) Radio-frequency tissue ablation in liver trauma: an experimental study Am Surg 70: 989–993PubMed
4.
go back to reference Felekouras E, Kontos M, Pissanou T, Pikoulis E, Drakos E, Papalambros E, Diamantis T, Bastounis E (2004) A new spleen preserving technique using radiofrequency ablation technology J Trauma 57: 1225–1229PubMed Felekouras E, Kontos M, Pissanou T, Pikoulis E, Drakos E, Papalambros E, Diamantis T, Bastounis E (2004) A new spleen preserving technique using radiofrequency ablation technology J Trauma 57: 1225–1229PubMed
5.
go back to reference Habib NA, Spalding D, Navarra G, Nicholls J (2003) How we do a bloodless partial splenectomy Am J Surg 186: 164–106CrossRefPubMed Habib NA, Spalding D, Navarra G, Nicholls J (2003) How we do a bloodless partial splenectomy Am J Surg 186: 164–106CrossRefPubMed
6.
go back to reference Ho CM, (2002) Splenic cysts: a new approach to partial splenectomy Surg Endosc 16: 717 Ho CM, (2002) Splenic cysts: a new approach to partial splenectomy Surg Endosc 16: 717
7.
go back to reference Kaiwa Y, Kurokawa Y, Namini K, Matsumoto H, Satomi S (2000) Laparoscopic partial splenectomies for true splenic cysts. A report of two cases Surg Endosc 14: 865 Kaiwa Y, Kurokawa Y, Namini K, Matsumoto H, Satomi S (2000) Laparoscopic partial splenectomies for true splenic cysts. A report of two cases Surg Endosc 14: 865
8.
go back to reference Kontos M, Felekouras E, Drakos E, et al (2005) Radio-frequency tissue ablation in an experimental grade IV renal trauma: a preliminary report. Surg Endosc 19: 249–253. Epub 2004 Nov 11CrossRefPubMed Kontos M, Felekouras E, Drakos E, et al (2005) Radio-frequency tissue ablation in an experimental grade IV renal trauma: a preliminary report. Surg Endosc 19: 249–253. Epub 2004 Nov 11CrossRefPubMed
9.
go back to reference Lupo L, Gallerani A, Aquilino F, Di Palma G, De Fazio M, Guglielmi A, Memeo V (2003) Anatomical hepatic relation using radiofrequency thermoablation in the treatment of primary or secondary liver tumors Tumori 89(suppl): 105–106PubMed Lupo L, Gallerani A, Aquilino F, Di Palma G, De Fazio M, Guglielmi A, Memeo V (2003) Anatomical hepatic relation using radiofrequency thermoablation in the treatment of primary or secondary liver tumors Tumori 89(suppl): 105–106PubMed
10.
go back to reference Morgenstern L, Verham R, Weinstein I, Phillips EH (1993) Subtotal splenectomy for Gaucher’s disease: a follow-up study Am Surg 59: 860–865PubMed Morgenstern L, Verham R, Weinstein I, Phillips EH (1993) Subtotal splenectomy for Gaucher’s disease: a follow-up study Am Surg 59: 860–865PubMed
11.
go back to reference Pampaloni F, Valeri A, Mattel R, Presenti L, Noccioli B, Tozzini S, Di Lollo S, Pampaloni A (2002) Laparoscopic decapsulation of a large epidermoid splenic cyst in a child using the UltraCisio LaparoSonic Coagulating Shears Pediatr Med Chir 24: 59–62PubMed Pampaloni F, Valeri A, Mattel R, Presenti L, Noccioli B, Tozzini S, Di Lollo S, Pampaloni A (2002) Laparoscopic decapsulation of a large epidermoid splenic cyst in a child using the UltraCisio LaparoSonic Coagulating Shears Pediatr Med Chir 24: 59–62PubMed
12.
go back to reference Peitzman AB, Ford HR, Harbrecht BG, Potoka DA, Townsend RN (2001) Injury to the spleen Curr Probl Surg 38: 921–1008CrossRef Peitzman AB, Ford HR, Harbrecht BG, Potoka DA, Townsend RN (2001) Injury to the spleen Curr Probl Surg 38: 921–1008CrossRef
13.
go back to reference Rice HE, Oldham KT, Hillery CA, Skinner MA, O’Hara SM, Ware RE (2003) Clinical and hematologic benefits of partial splenectomy for congenital hemolytic anemias in children Ann Surg 237: 281–288CrossRefPubMed Rice HE, Oldham KT, Hillery CA, Skinner MA, O’Hara SM, Ware RE (2003) Clinical and hematologic benefits of partial splenectomy for congenital hemolytic anemias in children Ann Surg 237: 281–288CrossRefPubMed
14.
go back to reference Seshadri PA, Poulin EC, Mamazza J, Schlachta CM (2000) Technique for laparoscopic partial splenectomy Surg Laparosc Endosc Percutan Tech 10: 106–109CrossRefPubMed Seshadri PA, Poulin EC, Mamazza J, Schlachta CM (2000) Technique for laparoscopic partial splenectomy Surg Laparosc Endosc Percutan Tech 10: 106–109CrossRefPubMed
15.
go back to reference Solbiati L, Goldberg SN, Ierace T, Livraghi T, Meloni F, Dellanoce M, Sironi S, Gazelle GS (1997) Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes Radiology 205: 367–373PubMed Solbiati L, Goldberg SN, Ierace T, Livraghi T, Meloni F, Dellanoce M, Sironi S, Gazelle GS (1997) Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes Radiology 205: 367–373PubMed
16.
go back to reference Thalhammer GH, Eber E, Uranus S, Pfeifer J, Zach MS (2003) Partial splenectomy in cystic fibrosis patients with hypersplenism Arch Dis Child 88: 143–146CrossRefPubMed Thalhammer GH, Eber E, Uranus S, Pfeifer J, Zach MS (2003) Partial splenectomy in cystic fibrosis patients with hypersplenism Arch Dis Child 88: 143–146CrossRefPubMed
17.
go back to reference Uranus S, Kronberger L, Kraft-Kine J (1994) Partial splenic resection using the TA-stapler Am J Surg 168: 49–53PubMed Uranus S, Kronberger L, Kraft-Kine J (1994) Partial splenic resection using the TA-stapler Am J Surg 168: 49–53PubMed
18.
go back to reference Van der Zee DC, Kramer WL, Ure BM, Mokhaberi B, Bax NM (1999) Laparoscopic management of a large posttraumatic splenic cyst in a child Surg Endosc 13: 1241–1242PubMed Van der Zee DC, Kramer WL, Ure BM, Mokhaberi B, Bax NM (1999) Laparoscopic management of a large posttraumatic splenic cyst in a child Surg Endosc 13: 1241–1242PubMed
19.
go back to reference Velanovich V, Weaver M (2003) Partial splenectomy using a coupled saline–radiofrequency hemostatic device Am J Surg 185: 66–68CrossRefPubMed Velanovich V, Weaver M (2003) Partial splenectomy using a coupled saline–radiofrequency hemostatic device Am J Surg 185: 66–68CrossRefPubMed
20.
go back to reference Weber JC, Navarra G, Habib NA, Bachellier P, Jaeck D (2003) Laparoscopic radiofrequency-assisted liver resection. Surg Endosc 17: 834CrossRef Weber JC, Navarra G, Habib NA, Bachellier P, Jaeck D (2003) Laparoscopic radiofrequency-assisted liver resection. Surg Endosc 17: 834CrossRef
21.
go back to reference Weber JC, Navarra G, Jiao LR, Nicholls JP, Jensen SL, Habib NA (2002) New technique for liver resection using heat coagulative necrosis Ann Surg 236: 560–563CrossRefPubMed Weber JC, Navarra G, Jiao LR, Nicholls JP, Jensen SL, Habib NA (2002) New technique for liver resection using heat coagulative necrosis Ann Surg 236: 560–563CrossRefPubMed
Metadata
Title
A novel spleen-preserving laparoscopic technique using radiofrequency ablation in a porcine model
Authors
E. Pikoulis
E. Felekouras
I. Papaconstantinou
M. Kontos
E. Prassas
I. Griniatsos
C. Bacoyiannis
P. Pappa
A. Papalois
C. Tsigris
A. Giannopoulos
E. Papalambros
J. Bramis
E. Bastounis
Publication date
01-10-2005
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2005
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-004-2219-y

Other articles of this Issue 10/2005

Surgical Endoscopy 10/2005 Go to the issue