The removal of the spleen that has been carried out for over hundred years through a large abdominal incision is another excellent option for the laparoscopic approach. Most patients requiring the removal of the spleen with this technique have ITP(idiopathic thrombocytopenic purpura). If the spleen is not extremely enlarged this technique can be also utilized for neoplastic disease processes.
Hospital Stay: 48 – 72 Hours
Type of Anesthesia: General
Operative Time: 120 – 180 minutes
Possible Complications: Bleeding, Infection, Sepsis
Pictures of the Operative Technique
Figure 1. Positioning of the patient and team. The patient in right lateral decubitus position. ANS, Anesthetist; S, surgeon; A1, A2, assistants; N, nurse; M, monitor
Figure 2. Trocar sites and instrumentation
Figure 3. Elevation of the stomach and view into the lesser sac
Figure 4. The splenic artery is clipped
Figure 5. Elevation of the spleen and dissection of the splenocolic ligament
Figure 6. Dissection of hilar and splenorenal ligaments
Figure 7. Transection of spleen hilum with the enocutter
Figure 8. Transection of short gastric vessels
Figure 9. Placement of specimen into bag. Note placement of graspers holding the bag
Figure 10. Exteriorization of the bag and morcellation of the specimen
