[Laparoscopic splenectomy]

From 1995 to 1998, 14 patients have been treated with laparoscopic splenectomy. Seven patients had immune thrombocytopenic purpura (ITP), six hereditary spherocytosis and one chronic myelomonocytic leukaemia with trombocytopenia. 12 of the patients had normal or nearly normal sized spleen. Median duration of surgery was 156 minutes and the median postoperative hospital stay four days. All operations were completed laparoscopically. Three patients had postoperative fever without any sign of infection, one developed urinary retention and one was readmitted with pneumonia. The patient with chronic myelomonocytic leukaemia died 15 days postoperatively from an intracerebral bleeding. Two patients suffer from relapse of trombocytopenia, one is treated with steroids. Laparoscopic splenectomy can be performed safely in patients with normal sized spleen with all the advantages of minimal access surgery. However, problems related to identification of accessory spleens and splenectomy in patients with splenomegali, should be further evaluated.