Mondragón SA, Carlos-Lazo M, Sánchez CRG, Quiroz GJA, Mondragón SR

Language: Spanish
References: 13
Page: 194-198
PDF size: 163.84 Kb.

ABSTRACT

Background: The benefits of laparoscopic surgery for procedures such as splenectomy for definitive treatment of hematological disease have a very important rol nowadays. Although there are special cases in which the size of the spleen is such that it could risk the success of the surgical procedure with standard instruments. In these cases the use of hand-assisted devices is an excellent alternative, preserving the benefits of minimally invasive surgery. We present a case of hand assisted splenectomy in massive splenomegaly.
Case report: A twenty year old male, familial history of spherocitosis. The diagnosis of hereditary spherocitosis was done and was medically treated, he had a history of recurrent jaundice and anemia. Surgical treatment was decided and ultrasound and computed tomography reported massive splenomegaly. A hand assisted splenectomy in an anterior-lateral position was performed, a 20 x 20n x 25 cm spleen weighting 1,600 g was found. Vascular dissection and control was done completely laparoscopic while the movilization and the spleen extraction were done after the application of the hand assisted port (Lapdisc). Bleeding was minimal and postoperative course was alright, the patient was discharged on the third postoperative day.
Conclusions: Hand assisted surgery is an excellent alternative for massive splenomegaly. The benefits of minimally invasive surgery are preserved, adding tactile sensation a the possibility to manipulate large lesions.

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