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Determination of intact splenic weight based on morcellated weight
R M Walsh1, B Chand, J Brodsky
1Department of General Surgery, Cleveland Clinic Foundation, Desk A80, 9500 Euclid Avenue, Cleveland, OH 44195, USA. walshm@ccf.org
Background:
Comparisons of splenic size based on splenic weight are difficult after laparoscopic splenectomy, which results in a morcellated specimen. We report the results of a direct comparison between morcellated and intact splenic weights.
Methods:
Porcine spleens were harvested via a midline laparotomy, and an intact splenic weight was obtained, which served as the control. The spleen then was placed into an impermeable retrieval bag and returned to the peritoneal cavity. A separate 10-mm incision was made and the spleen mechanically morcellated with a uterine forceps. This design most faithfully recreates the morcellation process during laparoscopic splenectomy in humans. The aggregate weight of the fragments was compared with intact splenic weight.
Results:
Intact and morcellated weights were obtained from 58 porcine spleens. The mean intact splenic weight was 145 g, and the mean morcellated weight was 78 g. For a given morcellated weight achieved at laparoscopic splenectomy, an estimated intact weight can be determined by the following formula: intact weight (g) = morcellated weight (g) x 1.34 + 45.
Conclusions:
On the basis of our calculations, a normal spleen weighing 150 g would have a mean morcellated weight of 78 g, and splenomegaly (intact spleen weighing 250 g or more) would be defined by a morcellated weight exceeding 153 g.