Skip to main content
Top
Published in: Langenbeck's Archives of Surgery 3/2013

01-03-2013 | Original Article

Partial spleen resection with a radiofrequency needle device—a pilot study

Authors: Juliane Liese, Sven Kohler, Christian Moench, Wolf Otto Bechstein, Frank Ulrich

Published in: Langenbeck's Archives of Surgery | Issue 3/2013

Login to get access

Abstract

Introduction

Total splenectomy leads to an immunocompromised state, with an increased lifetime risk of infection. The lifetime risk of developing overwhelming postsplenectomy infection is 5 %, with a mortality rate of approximately 50 %. In addition to vaccination and antibiotic prophylaxis, partial splenectomy is believed to improve patient safety.

Methods

We performed partial splenectomy in seven patients using a radiofrequency (RF) technique with Habib® needles. In seven patients, an open access partial splenectomy was performed. In three patients, a partial splenectomy was performed simultaneously with intraabdominal tumour resection. In two patients, the upper pole of the spleen was removed due to tumours of the spleen. In one patient, a large symptomatic splenic cyst was resected and in another patient, a partial splenectomy was performed due to trauma. RF was applied using Habib® needles (AngioDynamics, Manchester, GA, 31816, USA).

Results

The partial splenectomy procedures were easy and safe in all seven patients. The RF application with the Habib® needles led to primary haemostasis. The blood loss was less than 50 ml in all cases. After a minimum follow-up of 1 year, there were no cases of infections or other adverse events related to the previous partial splenectomy.

Conclusion

In our experience, partial splenectomy with Habib® needles is easy to perform and safe for the patient. Thus, radiofrequency resection is a good alternative to total splenectomy in many patients and reduces the risk of postsplenectomy infections.
Literature
1.
go back to reference Bisharat N, Omari H, Lavi I, Raz R (2001) Risk of infection and death among post-splenectomy patients. J Infect 3:182–186CrossRef Bisharat N, Omari H, Lavi I, Raz R (2001) Risk of infection and death among post-splenectomy patients. J Infect 3:182–186CrossRef
2.
go back to reference de Porto APNA, Lammers AJJ, Bennink RJ et al (2010) Assessment of splenic function. Eur J Cli Microbiol Infect Dis: Off Publ Eur Soc Clin Microbiol 12:1465–1473CrossRef de Porto APNA, Lammers AJJ, Bennink RJ et al (2010) Assessment of splenic function. Eur J Cli Microbiol Infect Dis: Off Publ Eur Soc Clin Microbiol 12:1465–1473CrossRef
3.
go back to reference Jones P, Leder K, Woolley I et al (2010) Postsplenectomy infection—strategies for prevention in general practice. Aust Fam Phys 6:383–386 Jones P, Leder K, Woolley I et al (2010) Postsplenectomy infection—strategies for prevention in general practice. Aust Fam Phys 6:383–386
4.
go back to reference Waghorn DJ (2001) Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed. J Clin Pathol 3:214–218CrossRef Waghorn DJ (2001) Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed. J Clin Pathol 3:214–218CrossRef
5.
go back to reference King H, Shumacker HB (1952) Splenic studies. Susceptibility to infection after splenectomy performed in infancy. Ann Surg 2:239–242CrossRef King H, Shumacker HB (1952) Splenic studies. Susceptibility to infection after splenectomy performed in infancy. Ann Surg 2:239–242CrossRef
6.
go back to reference Davidson RN, Wall RA (2001) Prevention and management of infections in patients without a spleen. Clin Microbiol Infect: Off Publ Eur Soc Clin Microbiol Infect Dis 12:657–660CrossRef Davidson RN, Wall RA (2001) Prevention and management of infections in patients without a spleen. Clin Microbiol Infect: Off Publ Eur Soc Clin Microbiol Infect Dis 12:657–660CrossRef
7.
go back to reference Holdsworth RJ, Irving AD, Cuschieri A (1991) Postsplenectomy sepsis and its mortality rate: actual versus perceived risks. Br J Surg 9:1031–1038CrossRef Holdsworth RJ, Irving AD, Cuschieri A (1991) Postsplenectomy sepsis and its mortality rate: actual versus perceived risks. Br J Surg 9:1031–1038CrossRef
8.
go back to reference Spelman D, Buttery J, Daley A et al (2008) Guidelines for the prevention of sepsis in asplenic and hyposplenic patients. Int Med J 5:349–356CrossRef Spelman D, Buttery J, Daley A et al (2008) Guidelines for the prevention of sepsis in asplenic and hyposplenic patients. Int Med J 5:349–356CrossRef
9.
go back to reference Cadili A, de Gara C (2008) Complications of splenectomy. Am J Med 5:371–375CrossRef Cadili A, de Gara C (2008) Complications of splenectomy. Am J Med 5:371–375CrossRef
10.
go back to reference Hassn A-F, Ouf S (2000) Portal vein thrombosis following splenectomy. Br J Surg 3:362–373CrossRef Hassn A-F, Ouf S (2000) Portal vein thrombosis following splenectomy. Br J Surg 3:362–373CrossRef
11.
go back to reference Ikeda M, Sekimoto M, Takiguchi S et al (2005) High incidence of thrombosis of the portal venous system after laparoscopic splenectomy: a prospective study with contrast-enhanced CT scan. Ann Surg 2:208–216CrossRef Ikeda M, Sekimoto M, Takiguchi S et al (2005) High incidence of thrombosis of the portal venous system after laparoscopic splenectomy: a prospective study with contrast-enhanced CT scan. Ann Surg 2:208–216CrossRef
12.
go back to reference Romano F, Caprotti R, Conti M et al (2006) Thrombosis of the splenoportal axis after splenectomy. Langenbeck’s Arch Surg/Verh Dtsch Chir 5:483–488CrossRef Romano F, Caprotti R, Conti M et al (2006) Thrombosis of the splenoportal axis after splenectomy. Langenbeck’s Arch Surg/Verh Dtsch Chir 5:483–488CrossRef
13.
go back to reference Pai M, Navarra G, Ayav A et al (2008) Laparoscopic Habib 4X: a bipolar radiofrequency device for bloodless laparoscopic liver resection. HPB: Off J Int Hepato Pancreato Biliary Assoc 4:261–264CrossRef Pai M, Navarra G, Ayav A et al (2008) Laparoscopic Habib 4X: a bipolar radiofrequency device for bloodless laparoscopic liver resection. HPB: Off J Int Hepato Pancreato Biliary Assoc 4:261–264CrossRef
14.
go back to reference Pai M, Frampton AE, Mikhail S et al (2012) Radiofrequency assisted liver resection: analysis of 604 consecutive cases. Eur J Surg Oncol: J Eur Soc Surg Oncol Br Assoc Surg Oncol 3:274–280CrossRef Pai M, Frampton AE, Mikhail S et al (2012) Radiofrequency assisted liver resection: analysis of 604 consecutive cases. Eur J Surg Oncol: J Eur Soc Surg Oncol Br Assoc Surg Oncol 3:274–280CrossRef
15.
go back to reference Ayav A, Jiao L, Dickinson R et al. (2008) Liver resection with a new multiprobe bipolar radiofrequency device. Arch Surg (Chicago, IL: 1960) 4:396–401, discussion 401 Ayav A, Jiao L, Dickinson R et al. (2008) Liver resection with a new multiprobe bipolar radiofrequency device. Arch Surg (Chicago, IL: 1960) 4:396–401, discussion 401
16.
go back to reference Curro G, Habib N, Jiao L et al (2008) Radiofrequency-assisted liver resection in patients with hepatocellular carcinoma and cirrhosis: preliminary results. Transplant Proc 10:3523–3525CrossRef Curro G, Habib N, Jiao L et al (2008) Radiofrequency-assisted liver resection in patients with hepatocellular carcinoma and cirrhosis: preliminary results. Transplant Proc 10:3523–3525CrossRef
17.
go back to reference Moore EE, Cogbill TH, Jurkovich GJ et al (1995) Organ injury scaling: spleen and liver (1994 revision). J Trauma 3:323–324CrossRef Moore EE, Cogbill TH, Jurkovich GJ et al (1995) Organ injury scaling: spleen and liver (1994 revision). J Trauma 3:323–324CrossRef
18.
go back to reference Patrzyk M, Glitsch A, Hoene A et al (2011) Laparoscopic partial splenectomy using a detachable clamp with and without partial splenic embolisation. Langenbeck’s Arch Surg/Verh Dtsch Chir 3:397–402CrossRef Patrzyk M, Glitsch A, Hoene A et al (2011) Laparoscopic partial splenectomy using a detachable clamp with and without partial splenic embolisation. Langenbeck’s Arch Surg/Verh Dtsch Chir 3:397–402CrossRef
19.
go back to reference Zacharoulis D, Poultsidis A, Katsogridakis E et al (2008) Radiofrequency-assisted partial splenectomy: histopathological and immunological assessment of the splenic remnant in a porcine model. Surg Endosc 5:1309–1316CrossRef Zacharoulis D, Poultsidis A, Katsogridakis E et al (2008) Radiofrequency-assisted partial splenectomy: histopathological and immunological assessment of the splenic remnant in a porcine model. Surg Endosc 5:1309–1316CrossRef
20.
go back to reference Vasilescu C, Tudor S, Popa M et al (2010) Robotic partial splenectomy for hydatid cyst of the spleen. Langenbeck’s Arch Surg/Verh Dtsch Chir 8:1169–1174CrossRef Vasilescu C, Tudor S, Popa M et al (2010) Robotic partial splenectomy for hydatid cyst of the spleen. Langenbeck’s Arch Surg/Verh Dtsch Chir 8:1169–1174CrossRef
21.
go back to reference Bork U, Müller SA, Herpel E et al (2011) Partial splenectomy using a vascular stapler in a patient with a benign splenic cyst. Am Surg 1:118–119 Bork U, Müller SA, Herpel E et al (2011) Partial splenectomy using a vascular stapler in a patient with a benign splenic cyst. Am Surg 1:118–119
22.
go back to reference Haghighi KS, Steinke K, Hazratwala K et al (2005) Controlled study of in-line ovine spleen transection assisted by radiofrequency ablation. J Trauma 4:841–844CrossRef Haghighi KS, Steinke K, Hazratwala K et al (2005) Controlled study of in-line ovine spleen transection assisted by radiofrequency ablation. J Trauma 4:841–844CrossRef
23.
go back to reference Pikoulis E, Felekouras E, Papaconstantinou I et al (2005) A novel spleen-preserving laparoscopic technique using radiofrequency ablation in a porcine model. Surg Endosc 10:1329–1332CrossRef Pikoulis E, Felekouras E, Papaconstantinou I et al (2005) A novel spleen-preserving laparoscopic technique using radiofrequency ablation in a porcine model. Surg Endosc 10:1329–1332CrossRef
24.
go back to reference Velanovich V, Weaver M (2003) Partial splenectomy using a coupled saline-radiofrequency hemostatic device. Am J Surg 1:66–68CrossRef Velanovich V, Weaver M (2003) Partial splenectomy using a coupled saline-radiofrequency hemostatic device. Am J Surg 1:66–68CrossRef
25.
go back to reference Habib NA, Spalding D, Navarra G, Nicholls J (2003) How we do a bloodless partial splenectomy. Am J Surg 2:164–166CrossRef Habib NA, Spalding D, Navarra G, Nicholls J (2003) How we do a bloodless partial splenectomy. Am J Surg 2:164–166CrossRef
26.
go back to reference Itamoto T, Fukuda S, Tashiro H et al (2006) Radiofrequency-assisted partial splenectomy with a new and simple device. Am J Surg 2:252–254CrossRef Itamoto T, Fukuda S, Tashiro H et al (2006) Radiofrequency-assisted partial splenectomy with a new and simple device. Am J Surg 2:252–254CrossRef
27.
go back to reference Jiao LR, Tierris I, Ayav A et al (2006) A new technique for spleen preservation with radiofrequency. Surgery 3:464–466CrossRef Jiao LR, Tierris I, Ayav A et al (2006) A new technique for spleen preservation with radiofrequency. Surgery 3:464–466CrossRef
28.
go back to reference de Greef E, Hoffman I, Topal B et al (2008) Partial laparoscopic splenectomy for splenic abscess because of Salmonella infection: a case report. J Pediatr Surg 5:E35–E38CrossRef de Greef E, Hoffman I, Topal B et al (2008) Partial laparoscopic splenectomy for splenic abscess because of Salmonella infection: a case report. J Pediatr Surg 5:E35–E38CrossRef
29.
go back to reference Gumbs AA, Bouhanna P, Bar-Zakai B et al (2008) Laparoscopic partial splenectomy using radiofrequency ablation. J Laparoendosc Adv Surg Tech Part A 4:611–613CrossRef Gumbs AA, Bouhanna P, Bar-Zakai B et al (2008) Laparoscopic partial splenectomy using radiofrequency ablation. J Laparoendosc Adv Surg Tech Part A 4:611–613CrossRef
30.
go back to reference Rasekhi AR, Naderifar M, Bagheri MH et al (2009) Radiofrequency ablation of the spleen in patients with thalassemia intermedia: a pilot study. AJR Am J Roentgenol 5:1425–1429CrossRef Rasekhi AR, Naderifar M, Bagheri MH et al (2009) Radiofrequency ablation of the spleen in patients with thalassemia intermedia: a pilot study. AJR Am J Roentgenol 5:1425–1429CrossRef
31.
go back to reference Bong JJ, Kumar R, Spalding D (2011) A novel technique of partial splenectomy using radiofrequency ablation. J Gastrointest Surg: Off J Soc Surg Aliment Tract 2:371–372CrossRef Bong JJ, Kumar R, Spalding D (2011) A novel technique of partial splenectomy using radiofrequency ablation. J Gastrointest Surg: Off J Soc Surg Aliment Tract 2:371–372CrossRef
32.
go back to reference Karadayi K, Turan M, Sen M (2011) A new technique for partial splenectomy with radiofrequency technology. Surg Laparosc Endosc Percutaneous Tech 5:358–361CrossRef Karadayi K, Turan M, Sen M (2011) A new technique for partial splenectomy with radiofrequency technology. Surg Laparosc Endosc Percutaneous Tech 5:358–361CrossRef
33.
go back to reference Khelif K, Maassarani F, Dassonville M, de Laet M-H (2006) Laparoscopic partial splenectomy using radiofrequency ablation for nonparasitic splenic cysts in two children. J Laparoendosc Adv Surg Tech Part A 4:414–417CrossRef Khelif K, Maassarani F, Dassonville M, de Laet M-H (2006) Laparoscopic partial splenectomy using radiofrequency ablation for nonparasitic splenic cysts in two children. J Laparoendosc Adv Surg Tech Part A 4:414–417CrossRef
34.
go back to reference Pai M, Jiao LR, Khorsandi S et al (2008) Liver resection with bipolar radiofrequency device: Habib 4X. HPB: Off J Int Hepato Pancreato Biliary Assoc 4:256–260CrossRef Pai M, Jiao LR, Khorsandi S et al (2008) Liver resection with bipolar radiofrequency device: Habib 4X. HPB: Off J Int Hepato Pancreato Biliary Assoc 4:256–260CrossRef
35.
go back to reference Pai M, Spalding D, Jiao L, Habib N (2012) Use of bipolar radiofrequency in parenchymal transection of the liver, pancreas and kidney. Dig Surg 1:43–47CrossRef Pai M, Spalding D, Jiao L, Habib N (2012) Use of bipolar radiofrequency in parenchymal transection of the liver, pancreas and kidney. Dig Surg 1:43–47CrossRef
36.
go back to reference Pai M, Frampton AE, Mikhail S et al (2012) Radiofrequency assisted liver resection: analysis of 604 consecutive cases. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Sur Oncol 3:274–280CrossRef Pai M, Frampton AE, Mikhail S et al (2012) Radiofrequency assisted liver resection: analysis of 604 consecutive cases. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Sur Oncol 3:274–280CrossRef
37.
go back to reference Szczepanik AB, Meissner AJ (2009) Partial splenectomy in the management of nonparasitic splenic cysts. World J Surg 4:852–856CrossRef Szczepanik AB, Meissner AJ (2009) Partial splenectomy in the management of nonparasitic splenic cysts. World J Surg 4:852–856CrossRef
Metadata
Title
Partial spleen resection with a radiofrequency needle device—a pilot study
Authors
Juliane Liese
Sven Kohler
Christian Moench
Wolf Otto Bechstein
Frank Ulrich
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 3/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-013-1054-9

Other articles of this Issue 3/2013

Langenbeck's Archives of Surgery 3/2013 Go to the issue