Laparoscopic Partial Splenectomy: A Preferred Method for Select Patients

J Laparoendosc Adv Surg Tech A. 2016 Dec;26(12):1010-1014. doi: 10.1089/lap.2016.0150. Epub 2016 Jul 28.

Abstract

Background: The purpose of this study was to explore the feasibility and safety of laparoscopic partial splenectomy (LPS) using a harmonic scalpel (HS) combined with bipolar coagulation.

Materials and methods: Using HS and bipolar coagulation technology, 18 patients suffering from splenic cystic neoplasm were treated with LPS between January 2010 and December 2014, and their clinical data were analyzed retrospectively.

Results: LPS was performed successfully without conversion to open surgery in all cases. The mean intra-operative blood loss was 75.8 ± 33.5 mL, and the mean operation time was 54.3 ± 16.6 minutes (range, 48-82 minutes). No cases of postoperative bleeding, infection, or pancreatic fistula occurred. No patient required total splenectomy. The mean hospital stay was 6.6 ± 3.2 days, and the median postoperative follow-up was 19.8 months (range, 5-60 months). All patients recovered successfully, with normal complete blood counts and without any recurrence on follow-up.

Conclusions: LPS is a safe and feasible operation for selected patients. Combined use of an HS and bipolar coagulation can shorten the operation time, reduce blood loss, and improve the safety of the operation.

Keywords: bipolar coagulation; harmonic scalpel; laparoscopic partial splenectomy.

MeSH terms

  • Adolescent
  • Adult
  • Blood Loss, Surgical / statistics & numerical data
  • Child
  • Child, Preschool
  • Conversion to Open Surgery / statistics & numerical data
  • Electrocoagulation / methods
  • Epidermal Cyst / surgery*
  • Feasibility Studies
  • Female
  • Hemangioma / surgery*
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Lymphangioma / surgery*
  • Male
  • Operative Time
  • Patient Selection
  • Postoperative Complications / epidemiology
  • Recurrence
  • Retrospective Studies
  • Splenectomy / methods*
  • Splenic Diseases / surgery
  • Splenic Neoplasms / surgery*
  • Treatment Outcome
  • Young Adult