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Hand-assisted laparoscopic splenectomy in the setting of splenomegaly
G K Kaban1, D R Czerniach, R Cohen
1Department of Surgery, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01655, USA. kabang@ummhc.org
Background:
Hand-assisted laparoscopic surgery (HALS) devices may be well suited to splenectomy in cases of splenomegaly.
Methods:
All cases of HALS for splenectomy between 1997 and 2001 were reviewed. Patient characteristics, operative details, and morbidity and mortality were analyzed.
Results:
HALS for splenectomy was performed in 54 patients. A total of 39 patients with massive splenomegaly (MS) (>600 g) were identified. The average weight of the MS group was 1285 +/- 505 g. There was one (3%) conversion. Operative time was 159 +/- 65 min, estimated blood loss was 257 +/- 240 ml, and length of hospital stay was 5.4 +/- 2.9 days. Morbidity was limited to 13 patients (24%), and there were two postoperative mortalities (5.1%).
Conclusions:
HALS for splenectomy in the setting of splenomegaly is feasible and safe. For the surgeon considering a laparoscopic approach in the setting of splenomegaly, a hand-assisted technique is ideally suited for removal of the enlarged spleen.