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2014, Number 1

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Rev Mex Cir Pediatr 2014; 18 (1)

Laparoscopic splenectomy. report of a different approach

Alba PR

Language: Spanish
References: 13
Page: 19-26
PDF size: 200.42 Kb.


ABSTRACT

Introduction: Laparoscopic splenectomy (LS) has become the standard procedure for most cases of splenectomy. Bleeding is the main complication and cause of conversion. We present our experience with an anterior approach and the Ligasure™ to discuss its advantages as a safe blood vessel sealing system, with a better mobilization and visualization of the splenic hilum.
Material and Methods: During a 3 years period, from January 2009 to January 2012, we preformed 12 consecutive LS and Ligasure™ anterior approach in our center. We conducted a systematic review of all patients undergoing LS with Ligasure™ to achieve vascular control and those with an anterior approach. We evaluated the benefits and results.
Results: Twelve LS were performed. Eleven of these patients had Idiopathic thrombocytopenic purpura (ITP), and one patient had hereditary spherocytosis. The average blood loss was 70 ml (range, 50-110), surgical time was 80 minutes (range, 70-120). No postoperative complications.
Discussion: The literature review revealed eight studies with 231 cases in which the Ligasure™ was used to perform LS. A significant reduction in operating time (average 102 minutes) and the loss of intra-abdominal blood (66ml) was observed with the Ligasure™ compared with cutting staples.
Conclusions: Using Ligasure™ and anterior approach results in a time saving and safe technique plus low trans-surgical bleeding, low need for transfusion, minimal complications and very low conversion rate.


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