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Hand-assisted laparoscopic splenectomy for ruptured spleen.
1Division of Laparoscopic Surgery, Department of Surgery, Mount Sinai Medical Center, 1 Gustave L. Levy Place, Box 1103, New York, NY 10029, USA. christine_ren@hotmail.com
Surgical Endoscopy
|May 19, 2001
Summary
Laparoscopic splenectomy for splenic rupture is challenging due to bleeding. A hand-assist device enabled a successful laparoscopic splenectomy, avoiding open surgery in a trauma case.
Area of Science:
- Surgical innovation
- Minimally invasive surgery
- Trauma surgery
Background:
- Laparoscopic splenectomy is accepted for elective procedures but controversial in trauma.
- Splenic rupture presents challenges for laparoscopy, including vascular control and visibility.
- Few reports exist on laparoscopic splenorrhaphy for trauma, none on splenectomy.
Observation:
- A case of splenic rupture in a trauma setting was managed surgically.
- Laparoscopic approach was initially considered but faced typical obstacles like bleeding.
- A hand-assist device was employed to overcome laparoscopic limitations.
Findings:
- The hand-assist device facilitated tactile sensation and immediate vascular control.
- This allowed conversion from a standard laparoscopic approach to a hand-assisted laparoscopic splenectomy.
- The procedure successfully managed the splenic rupture, avoiding laparotomy.
Implications:
- Hand-assist devices can be a valuable tool in complex laparoscopic trauma surgery.
- This technique offers an alternative to open surgery (laparotomy) in cases of splenic rupture.
- Further exploration of hand-assist devices in trauma laparoscopy is warranted.