[Laparoscopic and open splenectomy for idiopathic thrombocytopenic purpura]

Idiopathic thrombocytopenic purpura(ITP) is an immune disorder, which causes an acute or chronic thrombocytopenia, and may result in potentially life-threatening hemorrhage. Splenectomy is one of the treatment options that needs to be weighted in the treatment of ITP, particularly in cases that have shown response failure to medical modalities such as prednisone, or anti-D globulin therapy. However, because open splenectomy (OS) requires more surgical invasiveness, surgical treatment had not been accepted for many patients with ITP. Recently, laparoscopic splenectomy(LS) is being accepted as an effective alternative to OS in treating ITP. The most important parts of this method are, mobilization of the spleen by dissection of the splenic ligament, and the blocking of blood circulation to the spleen by division of the hilar arteries and veins. The procedure is as follows: (1) The patient is in a right lateral decubitus position. (2) The resection of the splenic ligament is made by an ultrasonic coagulating dissector. (3) The splenic hilum is dissected with an auto-stapler. (4) The freed spleen is contained in a nylon bag and extracted. Laparoscopic splenectomy is a feasible and safe for patients with ITP.