Laparoscopic splenectomy in cases of splenomegaly has been shown to be feasible in experienced hands, even though the size of the spleen increases the operative time and difficulty. Laparoscopic splenectomy for splenomegaly offers the same advantages as for patients with smaller spleens: a shorter hospital stay and a faster recovery. Recent experience has shown that hand-assisted laparoscopic surgery makes the surgical maneuvers during laparoscopic splenectomy in cases of splenomegaly considerably easier while preserving the advantages of a purely laparoscopic approach. This technique may facilitate and broaden the application of laparoscopy for splenectomy in patients with enlarged spleens.
Get full access to this article
View all access options for this article.
References
1.
1. Park A , Targarona EM , Trias M : Laparoscopic surgery of the spleen: state of the art . Langenbecks J Surg386: 230-239 , 2001.
2.
2. Targarona EM , Espert JJ , Balague C , et al: Impact of splenic size on splenectomy outcome: a comparison between open and laparoscopic surgery . Surg Endosc13: 559-562 , 1999.
3.
3. Poulin EC , Thibault C : Laparoscopic splenectomy for massive splenomegaly: Operative technique and case report . Can J Surg38: 69-72 , 1995.
4.
4. Yee JC , Akpata MO : Laparoscopic splenectomy for congenital spherocytosis with splenomegaly: A case report . Can J Surg38: 73-76 , 1995.
6. Terrosu G , Donini A , Baccarani U , et al: Laparoscopic versus open splenectomy in the management of splenomegaly: Our preliminary experience . Surgery124: 839-843 , 1998.
7.
7. Hellmann P , Ardvinsson D , Rastad J : Handport-assisted laparoscopic splenectomy in massive splenomegaly . Surg Endosc14: 1177-1179 , 2000.
8.
8. Greene AK , Hodin RA : Laparoscopic splenectomy for massive splenomegaly using a Lahey bag . Am J Surg181: 543-546 , 2001.
9.
9. Heniford BT , Park A , Walsh RM , et al: Laparoscopic splenectomy in patients with normal sized spleens vs splenomegaly: Does the size matter?Am Surg67: 854-858 , 2001.
10.
10. Targarona EM , Espert JJ , Balague C , et al: Splenomegaly should not be considered a contraindication for laparoscopic splenectomy . Ann Surg228: 35-39 , 1998.
11.
11. Targarona EM , Balague C , Cerdan G , et al: Hand-assisted laparoscopic splenectomy (HALS) in cases of splenomegaly: A comparison analysis with conventional laparoscopic splenectomy . Surg Endosc16: 426-430 , 2002.
12.
12. Kercher KW , Matthews BD , Walsh RM , et al: Laparoscopic splenectomy for massive splenomegaly . Am J Surg183: 192-196 , 2002.
13.
13. Terrosu G , Baccarani U , Bresadola , et al: The impact of splenic weight on laparoscopic splenectomy for splenomegaly . Surg Endosc16: 103-107 , 2002.
14.
14. Ailawadi G , Yahanda A , Dimick JB , et al: Hand-assisted laparoscopic splenectomy in patients with splenomegaly or prior upper abdominal operation . Surgery132: 689-694 , 2002.
15.
15. Rosen M , Brody F , Walsh RM , Ponsky J : Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly . Arch Surg137: 1348-1352 , 2002.
16.
16. Borrazzo EC , Daly JM , Morrisey KP , et al: Hand-assisted laparoscopic splenectomy for giant spleens . Surg Endosc17: 918-920 , 2003.
17.
17. Knauer EM , Ailawadi G , Yahanda A , et al: 101 laparoscopic splenectomies for the treatment of benign and malignant hematologic disorders . Am J Surg186: 500-504 , 2003.
18.
18. Patel AG , Parker JE , Wallwork B , et al: Massive splenomegaly is associated with significant morbidity after laparoscopic splenectomy . Ann Surg238: 235-340 , 2003.
19.
19. Smith L , Luna G , Merg AR , et al: Laparoscopic splenectomy for treatment of splenomegaly . Am J Surg187: 618-620 , 2004.
20.
20. Choy C , Cacchione R , Moon , Ferzli G : Experience with seven cases of massive splenomegaly . J Laparoendosc Adv Surg Tech A14: 197-200 , 2004.
21.
21. Hiatt JR , Gomes AS , Machleder H : Massive splenomegaly . Arch Surg125: 1363-1367 , 1990.
22.
22. Dantforth DN , Fraker DL : Splenectomy for the massively enlarged spleen . Am Surg57: 108-113 , 1991.
23.
23. Farid H , O'Connell TX : Surgical management of massive splenomegaly . Am Surg62: 803-805 , 1996.
24.
24. Letoquart JP , La Gamma A , Kunin N , et al: Splenectomy for splenomegaly exceeding 1000 grams: Analysis of 47 patients . Br J Surg80: 334-335 , 1993.
25.
25. Glehen O , Caillot JL , Francois Y , et al: Splenectomie pour splenomegalie de plus de 100 g . Ann Chir51: 1099-1105 , 1997.
26.
26. McAneny D , LaMorte W , Scott TE , et al: Is splenectomy more dangerous for massive spleens?Am J Surg175: 102-107 , 1998.
27.
27. Nelson EW , Mone MC : Splenectomy in high risk patients with splenomegaly . Am J Surg178: 581-586 , 1999.
28.
28. Trias M , Targarona EM , Espert JJ , et al: Impact of hematological diagnosis on early and late outcome after laparoscopic splenectomy . Surg Endosc14: 555-560 , 2000.
29.
29. Targarona EM , Espert JJ , Bombuy E , et al: Complications of laparoscopic splenectomy . Arch Surg135: 1137-1140 , 2000.
30.
30. Mahon D , Rhodes M : Laparoscopic splenectomy: Size matters . Ann R Coll Surg Engl85: 248-251 , 2003.
31.
31. Katkhouda N , Lord R : Once more, with feeling. Handoscopy or the rediscovery of the virtues of the surgeon's hand . Surg Endosc14: 985-986 , 2000.
32.
32. Litwin DE , Darzi A , Jakimowicz J , et al: Hand-assisted laparoscopic surgery (HALS) with the Hand Port system: Initial experience with 68 patients . Ann Surg231: 715-723 , 2000.
33.
33. Targarona EM , Balague C , Trias M : Hand assisted laparoscopic splenectomy . Semin Laparosc Surg8: 126-134 , 2001.
34.
34. Poulin E , Thibault C , Mamazza J , et al: Laparoscopic splenectomy: Clinical experience and the role of preoperative splenic artery embolization . Surg Laparosc Endosc3: 445-350 , 1993.
35.
35. Iwase K , Higaki J , Yoon HE , et al: Splenic artery embolization using contour emboli before laparoscopic or laparoscopically assisted splenectomy . Surg Laparosc Endosc Percutan Tech12: 331-336 , 2002.
