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Updated: Aug 14, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Laparoscopic splenectomy for the treatment of refractory immune thrombocytopenia in pregnancy
Jill Griffiths1, Winnie Sia, A M James Shapiro
1Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
Background:
Immune thrombocytopenic purpura (ITP) is a condition with potential hazard during pregnancy for both mother and fetus if platelet concentrations fall below a critical level. This report describes the use of laparoscopic splenectomy following unsuccessful medical management.
Case:
A 35-year-old primigravid woman with systemic lupus erythematosis (SLE) developed ITP several years before becoming pregnant. She was treated early in pregnancy with high-dose oral prednisone and weekly intravenous immunoglobulin (IVIG) alternating with anti-D immune globulin, but laparoscopic splenectomy was indicated at 20 weeks' gestation because of thrombocytopenia. Following surgery, she continued prednisone and intermittent IVIG therapy until spontaneous delivery at 34 weeks' gestation. A small accessory spleen was identified postpartum by nuclear medicine scan. Satisfactory platelet concentrations were maintained postpartum using danazol and prednisone.
Conclusion:
Laparoscopic splenectomy is a therapeutic option for women with ITP during pregnancy that fails to respond to medical management.
