Hand-assisted laparoscopic splenectomy for giant spleens

• DOI: 10.1007/s00464-002-8946-z
• Publication Date: 2003-11-13T16:20:14Z
• Authors: E.C. Borrazzo; J.M. Daly; K.P. Morrisey; E. Fischer; M. Belmont; N.J. Hogle; D.L. Fowler
• Keywords: Adult; Male; Blood Volume; Time Factors; Blood Loss, Surgical; Organ Size; Length of Stay; Middle Aged; 3. Good health; Splenomegaly; Splenectomy; Humans; Female; Laparoscopy; Spleen; Aged

Laparoscopic splenectomy for massive splenomegaly is technically difficult, and the morcellated splenic tissue may be inadequate for histologic study. A hand-assisted technique may provide a technical advantage and allow removal of larger pieces of spleen.Patients who underwent hand-assisted laparoscopic splenectomy for massive splenomegaly were reviewed. Demographic information, operative data, and outcomes data were tabulated.Sixteen patients met these criteria. Mean age was 56 years (range, 35-78 years). Operating time averaged 240 min (range, 165-360 min), and median blood loss was 425 cc (range, 100-1800 cc). There were no conversions to an open procedure. Mean weight of extracted spleens was 2008 g (range, 543-4090 g). Postoperative length of stay averaged 3.3 days (range, 2-7 days). There was one postoperative complication (6.25%) and no mortality.Hand-assisted laparoscopic splenectomy for massive splenomegaly is feasible and safe while preserving the recovery benefits of minimal access surgery. It provides an adequate specimen for histologic study.