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Laparoscopic splenectomy using Ligasure. Preliminary experience.

F Romano1, R Caprotti, C Franciosi

  • 1Department of General Surgery, San Gerardo Hospital, II University of Milan-Bicocca. fabriziorom@hotmail.com

Surgical Endoscopy
|May 2, 2002
PubMed
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Laparoscopic splenectomy using the Ligasure Vessel Sealing System with a lateral approach significantly reduces intraoperative bleeding and operative time. This technique enhances safety and efficiency in spleen removal, minimizing complications.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Vascular Sealing

Background:

  • Intraoperative bleeding and conversion are primary complications of laparoscopic splenectomy.
  • Safe vascular control is crucial for successful laparoscopic splenectomy.

Purpose of the Study:

  • To evaluate the efficacy and safety of the Ligasure Vessel Sealing System combined with a lateral approach for laparoscopic splenectomy.
  • To assess the impact of this technique on intraoperative bleeding, operative time, and patient outcomes.

Main Methods:

  • A retrospective analysis of 35 laparoscopic splenectomies over 5 years.
  • The last 10 patients underwent spleen dissection and vessel sealing (lower pole, main pedicles, short gastric vessels) using the Ligasure system with a 4-trocar, right semilateral approach.

Related Experiment Videos

  • Patient indications included idiopathic thrombocytopenic purpura, hereditary spherocytosis, beta-thalassemia, and hemolytic anemia.

    • Main Results:

    • One conversion (10%) occurred due to hilar bleeding from an accidental Ligasure injury.
    • Average intraoperative blood loss was 80 mL (range 50-100 mL), with no blood transfusions required.
    • Average operative time was 120 minutes; one postoperative complication (spleno-portal axis thrombosis) was managed conservatively. Average hospital stay was 3.5 days.

    Conclusions:

    • The Ligasure Vessel Sealing System, when used with a lateral approach, improves operative time and safety during laparoscopic splenectomy.
    • This combined technique leads to significantly low intraoperative bleeding, enhancing the overall procedure's efficacy.