Abstract

VERGNAUD, Jean Pierre; LOPERA, Carlos  and  MATALLANA, Rogelio. Hand-assisted laparoscopic splenectomy Surgical technique in massive splenomegaly. rev. colomb. cir. [online]. 2005, vol.20, n.3, pp.166-171. ISSN 2011-7582.

Laparoscopic splenectomy has become the standard procedure for resection of the spleen. Several series suggest that hand-assisted laparoscopic splenectomy facilitates the procedure in cases of massive splenomegaly. Objective. To describe the surgical technique of hand-assisted laparoscopic splenectomy as a minimally invasive surgical option. Case presentation. Sixty five-year old female with massive splenomegaly. Technique. We started with a laparoscopic cholecystectomy followed by the placement of a hand port (Lap Disc® Johnson & Johnson) in Pfannestiel incision. Laparoscopic ports were placed, one in the umbilicus, and two subcostal at 5 cm from the border of the spleen. With the hand within the abdominal cavity, the spleen was retracted toward the midline and cephalically so as to ligate the polar vessels and free lateral adhesions. We proceeded to digitally isolate the hylar vessels and ligate them with the endoligature. The gastrosplenic ligament was freed with the harmonic scalpel and selective hemostasis was performed. The spleen was extracted and the procedure was terminated with closure of the ports.

Keywords : spleen; splenectomy; laparoscopy; hand-assisted procedure.

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