Hand-assisted laparoscopic splenectomy in the setting of splenomegaly

Surg Endosc. 2004 Sep;18(9):1340-3. doi: 10.1007/s00464-003-9175-9. Epub 2004 Jun 23.


Background: Hand-assisted laparoscopic surgery (HALS) devices may be well suited to splenectomy in cases of splenomegaly.

Methods: All cases of HALS for splenectomy between 1997 and 2001 were reviewed. Patient characteristics, operative details, and morbidity and mortality were analyzed.

Results: HALS for splenectomy was performed in 54 patients. A total of 39 patients with massive splenomegaly (MS) (>600 g) were identified. The average weight of the MS group was 1285 +/- 505 g. There was one (3%) conversion. Operative time was 159 +/- 65 min, estimated blood loss was 257 +/- 240 ml, and length of hospital stay was 5.4 +/- 2.9 days. Morbidity was limited to 13 patients (24%), and there were two postoperative mortalities (5.1%).

Conclusions: HALS for splenectomy in the setting of splenomegaly is feasible and safe. For the surgeon considering a laparoscopic approach in the setting of splenomegaly, a hand-assisted technique is ideally suited for removal of the enlarged spleen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Splenectomy / methods*
  • Splenic Diseases / complications
  • Splenic Diseases / surgery*
  • Splenomegaly / etiology
  • Splenomegaly / surgery*