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Published in: Journal of Gastrointestinal Surgery 2/2014

01-02-2014 | How I do it

Laparoscopic Splenectomy: Perioperative Management, Surgical Technique, and Results

Authors: P. Marco Fisichella, Yee M. Wong, Sam G. Pappas, Gerard J. Abood

Published in: Journal of Gastrointestinal Surgery | Issue 2/2014

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Abstract

Since their introduction in the early 1990s, minimally invasive techniques have gained widespread acceptance because of the significant benefits that patients are able to experience. Some of these benefits include reduced postoperative pain, earlier return to normal activity, and improved cosmesis when compared with open surgery. For these reasons, since its first description by Delaitre and Maignien in 1991, laparoscopic splenectomy (LS) has been increasingly utilized for a safe surgical removal of the spleen with nearly equivalent or superior short- and long-term outcomes when compared with the open approach. In this technical report, we aim to describe our preoperative and postoperative management of patients undergoing LS and to illustrate our preferred surgical technique, its rationale, and our results.
Literature
1.
go back to reference Carroll BJ, Phillips EH, Semel CJ, Fallas M, Morgenstern L. Laparoscopic splenectomy. Surg Endosc. 1992 Jul-Aug;6(4):183–5. PubMed PMID: 1387735. Epub 1992/07/01. eng. Carroll BJ, Phillips EH, Semel CJ, Fallas M, Morgenstern L. Laparoscopic splenectomy. Surg Endosc. 1992 Jul-Aug;6(4):183–5. PubMed PMID: 1387735. Epub 1992/07/01. eng.
2.
go back to reference Delaitre B, Maignien B. [Splenectomy by the laparoscopic approach. Report of a case]. Presse medicale. 1991 Dec 21–28;20(44):2263. PubMed PMID: 1838167. Splenectomie par voie coelioscopique. 1 observation (letter)]. Delaitre B, Maignien B. [Splenectomy by the laparoscopic approach. Report of a case]. Presse medicale. 1991 Dec 21–28;20(44):2263. PubMed PMID: 1838167. Splenectomie par voie coelioscopique. 1 observation (letter)].
3.
go back to reference Poulin E, Thibault C, Mamazza J, Girotti M, Cote G, Renaud A. Laparoscopic splenectomy: clinical experience and the role of preoperative splenic artery embolization. Surg Laparosc Endosc. 1993 Dec;3(6):445–50. PubMed PMID: 8269261. Epub 1993/12/01. eng. Poulin E, Thibault C, Mamazza J, Girotti M, Cote G, Renaud A. Laparoscopic splenectomy: clinical experience and the role of preoperative splenic artery embolization. Surg Laparosc Endosc. 1993 Dec;3(6):445–50. PubMed PMID: 8269261. Epub 1993/12/01. eng.
4.
go back to reference Thibault C, Mamazza J, Letourneau R, Poulin E. Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc. 1992 Sep;2(3):248–53. PubMed PMID: 1341540. Thibault C, Mamazza J, Letourneau R, Poulin E. Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc. 1992 Sep;2(3):248–53. PubMed PMID: 1341540.
5.
go back to reference Habermalz B, Sauerland S, Decker G, et al. Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2008 Apr;22(4):821–48. PubMed PMID: 18293036. Habermalz B, Sauerland S, Decker G, et al. Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2008 Apr;22(4):821–48. PubMed PMID: 18293036.
6.
go back to reference Bickenbach KA, Gonen M, Labow DM, et al. Indications for and efficacy of splenectomy for hematological disorders. Br J Surg. 2013 May;100(6):794–800. PubMed PMID: 23436638. Bickenbach KA, Gonen M, Labow DM, et al. Indications for and efficacy of splenectomy for hematological disorders. Br J Surg. 2013 May;100(6):794–800. PubMed PMID: 23436638.
7.
go back to reference Silecchia G, Boru CE, Fantini A, et al. Laparoscopic splenectomy in the management of benign and malignant hematologic diseases. JSLS. 2006 Apr-Jun;10(2):199–205. PubMed PMID: 16882420. Silecchia G, Boru CE, Fantini A, et al. Laparoscopic splenectomy in the management of benign and malignant hematologic diseases. JSLS. 2006 Apr-Jun;10(2):199–205. PubMed PMID: 16882420.
8.
go back to reference Walsh RM, Heniford BT. Laparoscopic splenectomy for non-Hodgkin lymphoma. J Surg Oncol. 1999 Feb;70(2);116–21. PubMed PMID: 10084655. Walsh RM, Heniford BT. Laparoscopic splenectomy for non-Hodgkin lymphoma. J Surg Oncol. 1999 Feb;70(2);116–21. PubMed PMID: 10084655.
9.
go back to reference Rosen M, Brody F, Walsh RM, Ponsky J. Hand-assisted laparoscopic splenectomy vs. conventional laparoscopic splenectomy in cases of splenomegaly. Arch Surg. 2002 Dec;137(12):1348–52. PubMed PMID: 12470097. Rosen M, Brody F, Walsh RM, Ponsky J. Hand-assisted laparoscopic splenectomy vs. conventional laparoscopic splenectomy in cases of splenomegaly. Arch Surg. 2002 Dec;137(12):1348–52. PubMed PMID: 12470097.
10.
go back to reference Wu Z, Zhou J, Li J, Zhu Y, Peng B. The feasibility of laparoscopic splenectomy for ITP patients without preoperative platelet transfusion. Hepatogastroenterology. 2012 Jan-Feb;59(113):81–5. PubMed PMID: 22260825 Wu Z, Zhou J, Li J, Zhu Y, Peng B. The feasibility of laparoscopic splenectomy for ITP patients without preoperative platelet transfusion. Hepatogastroenterology. 2012 Jan-Feb;59(113):81–5. PubMed PMID: 22260825
11.
go back to reference Wu Z, Zhou J, Pankaj P, Peng B. Laparoscopic splenectomy for immune thrombocytopenia (ITP) patients with platelet counts lower than 1 × 109/L. Int J Hematol. 2011 Dec;94(6):533–8. PubMed PMID: 22057433. Wu Z, Zhou J, Pankaj P, Peng B. Laparoscopic splenectomy for immune thrombocytopenia (ITP) patients with platelet counts lower than 1 × 109/L. Int J Hematol. 2011 Dec;94(6):533–8. PubMed PMID: 22057433.
12.
go back to reference Chen X, Peng B, Cai Y, Zhou J, Wang Y, Wu Z, et al. Laparoscopic splenectomy for patients with immune thrombocytopenia and very low platelet count: is platelet transfusion necessary? J Surg Res. 2011 Oct;170(2):e225-32. PubMed PMID: 21816423 Chen X, Peng B, Cai Y, Zhou J, Wang Y, Wu Z, et al. Laparoscopic splenectomy for patients with immune thrombocytopenia and very low platelet count: is platelet transfusion necessary? J Surg Res. 2011 Oct;170(2):e225-32. PubMed PMID: 21816423
13.
go back to reference Poulin EC, Mamazza J, Schlachta CM. Splenic artery embolization before laparoscopic splenectomy. An update. Surg Endosc. 1998 Jun;12(6):870–5. PMID: 9602009 Poulin EC, Mamazza J, Schlachta CM. Splenic artery embolization before laparoscopic splenectomy. An update. Surg Endosc. 1998 Jun;12(6):870–5. PMID: 9602009
14.
go back to reference Davies JM, Lewis MP, Wimperis J, Rafi I, Ladhani S, Bolton-Maggs PH, et al. Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen: prepared on behalf of the British Committee for Standards in Haematology by a working party of the Haemato-Oncology task force. British journal of haematology. 2011 Nov;155(3):308–17. PubMed PMID: 21988145. Davies JM, Lewis MP, Wimperis J, Rafi I, Ladhani S, Bolton-Maggs PH, et al. Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen: prepared on behalf of the British Committee for Standards in Haematology by a working party of the Haemato-Oncology task force. British journal of haematology. 2011 Nov;155(3):308–17. PubMed PMID: 21988145.
15.
go back to reference Poulin EC, Schlachta CM, Mamazza J. Chapter 20: Laparoscopic Splenectomy. ACS Surgery: Principles and Practice 2012. Poulin EC, Schlachta CM, Mamazza J. Chapter 20: Laparoscopic Splenectomy. ACS Surgery: Principles and Practice 2012.
16.
go back to reference Gossot D. Laparosopic splenectomy: value of the posterior approach. Ann Chir. 1998;52(9):940–5. PubMed PMID: 9882886 Gossot D. Laparosopic splenectomy: value of the posterior approach. Ann Chir. 1998;52(9):940–5. PubMed PMID: 9882886
17.
go back to reference Konstadoulakis MM, Lagoudianakis E, Antonakis PT, Albanopoulos K, Gomatos I, Stamou KM, et al. Laparoscopic versus open splenectomy in patients with beta thalassemia major. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A. 2006 Feb;16(1):5–8. PubMed PMID: 16494539. Konstadoulakis MM, Lagoudianakis E, Antonakis PT, Albanopoulos K, Gomatos I, Stamou KM, et al. Laparoscopic versus open splenectomy in patients with beta thalassemia major. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A. 2006 Feb;16(1):5–8. PubMed PMID: 16494539.
18.
go back to reference Vecchio R, Cacciola E, Lipari G, et al. Laparoscopic splenectomy reduces the need for platelet transfusion in patients with idiopathic thrombocytopenic purpura. JSLS. 2005 Oct-Dec;9(4):415–8. Vecchio R, Cacciola E, Lipari G, et al. Laparoscopic splenectomy reduces the need for platelet transfusion in patients with idiopathic thrombocytopenic purpura. JSLS. 2005 Oct-Dec;9(4):415–8.
19.
go back to reference Weiss CA 3rd, Kavic SM, Adrales GL, Park AE. Laparoscopic splenectomy: what barriers remain? Surg Innov. 2005 Mar;12(1):23–9. PubMed PMID: 15846443. Weiss CA 3rd, Kavic SM, Adrales GL, Park AE. Laparoscopic splenectomy: what barriers remain? Surg Innov. 2005 Mar;12(1):23–9. PubMed PMID: 15846443.
20.
go back to reference Heneghan HM, Annaberdyev S, Attaluri V, et al. Obesity does not adversely affect outcomes after laparoscopic splenectomy. Am J Surg. 2013 Jul;206(1):52–8. PubMed PMID: 23415136. Heneghan HM, Annaberdyev S, Attaluri V, et al. Obesity does not adversely affect outcomes after laparoscopic splenectomy. Am J Surg. 2013 Jul;206(1):52–8. PubMed PMID: 23415136.
21.
go back to reference Dominguez EP, Choi YU, Scott BG, et al. Impact of morbid obesity on outcome of laparoscopic splenectomy. Surg Endosc. 2007 Mar;21(3):422–6. PubMed PMID: 17103267. Dominguez EP, Choi YU, Scott BG, et al. Impact of morbid obesity on outcome of laparoscopic splenectomy. Surg Endosc. 2007 Mar;21(3):422–6. PubMed PMID: 17103267.
22.
go back to reference Pietrabissa A, Morelli L, Peri A, et al. Laparoscopic treatment of splenomegaly: a case for hand-assisted laparoscopic surgery. Arch Surg. 2011 Jul;146(7):818–23. PubMed PMID: 21768428. Pietrabissa A, Morelli L, Peri A, et al. Laparoscopic treatment of splenomegaly: a case for hand-assisted laparoscopic surgery. Arch Surg. 2011 Jul;146(7):818–23. PubMed PMID: 21768428.
23.
go back to reference Kaban GK, Czerniach DR, Cohen R, et al. Hand-assisted laparoscopic splenectomy in the setting of splenomegaly. Surg Endosc. 2004 Sep;18(9):1340–3. PubMed PMID: 15803233. Kaban GK, Czerniach DR, Cohen R, et al. Hand-assisted laparoscopic splenectomy in the setting of splenomegaly. Surg Endosc. 2004 Sep;18(9):1340–3. PubMed PMID: 15803233.
24.
go back to reference Targarona EM, Espert JJ, Bombuy E, et al. Complications of laparoscopic splenectomy. Arch Surg. 2000 Oct;135(10):1137–40. PubMed PMID: 11030868. Targarona EM, Espert JJ, Bombuy E, et al. Complications of laparoscopic splenectomy. Arch Surg. 2000 Oct;135(10):1137–40. PubMed PMID: 11030868.
25.
go back to reference Chand B, Walsh RM, Ponsky J, Brody F. Pancreatic complications following laparoscopic splenectomy. Surg Endosc. 2001 Nov;15(11):1273–6. PubMed PMID: 11727132. Chand B, Walsh RM, Ponsky J, Brody F. Pancreatic complications following laparoscopic splenectomy. Surg Endosc. 2001 Nov;15(11):1273–6. PubMed PMID: 11727132.
Metadata
Title
Laparoscopic Splenectomy: Perioperative Management, Surgical Technique, and Results
Authors
P. Marco Fisichella
Yee M. Wong
Sam G. Pappas
Gerard J. Abood
Publication date
01-02-2014
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 2/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-013-2366-3

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