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Updated: Jul 2, 2026
Application of Microwave Ablation in Laparoscopic Partial Splenectomy
Published on: November 15, 2024
Laparoscopic partial splenectomy using radiofrequency ablation
Andrew A Gumbs1, Philippe Bouhanna, Barak Bar-Zakai
1Department of Medical and Surgical Digestive Diseases, Institut Mutualiste Montsouris, University Paris V, Paris, France.
Insights
Laparoscopic partial splenectomy using radiofrequency ablation and hemostatic sponges effectively minimized blood loss in a patient with an epidermoid splenic cyst. This minimally invasive approach offers a promising alternative to traditional techniques for splenic cyst treatment.
Area of Science:
- Minimally invasive surgery
- Surgical oncology
- Medical devices
Background:
- Epidermoid splenic cysts are congenital and often affect pediatric patients.
- Partial splenectomy is preferred over total splenectomy to preserve immunologic function.
- Laparoscopic partial splenectomy is desirable but limited by hemostasis concerns.
Observation:
- A 25-year-old female presented with a 10-cm splenic cyst.
- Minimally invasive partial splenectomy was performed using radiofrequency ablation and a hemostatic sponge.
- The procedure was uneventful with minimal blood loss.
Findings:
- Final pathology confirmed an epidermoid splenic cyst.
- Estimated blood loss was less than 30 mL.
- The patient was discharged on postoperative day 5.
Implications:
- Radiofrequency ablation is suitable for partial splenectomy, complementing its use in hepatic procedures.
- Combining radiofrequency ablation with hemostatic sponges minimizes intraoperative and postoperative blood loss.
- Further randomized trials are needed to compare this technique with traditional methods.
Introduction:
Epidermoid cysts are believed to be congenital in origin and often present in the pediatric population. Because of the concerns of compromised immunologic function after total splenectomy and increasing demand for minimally invasive approaches, interest has increased in performing the partial splenectomy in this patient population by laparoscopic techniques. Nonetheless, concerns for adequate hemostasis have limited its widespread adoption. Because radiofrequency ablation for the partial splenectomy has been done in a laparoscopic porcine model with good results, we used this technology with the goal of limiting blood loss and postoperative hemorrhagic complications.
Case Report:
A 25-year-old female presented with complaints of right shoulder pain. Abdominal ultrasound and a computed tomography (CT) scan revealed a 10-cm cystic lesion of the spleen. Serology was negative for hydatid cyst pathology. The patient underwent an uneventful partial splenectomy by minimally invasive techniques with the aid of a laparoscopic radiofrequency ablative device and the placement of a hemostatic medicated sponge along the line of transection.
Results:
Estimated blood loss was less than 30 mL. Final pathology was consistent with an epidermoid splenic cyst, and the patient was discharged uneventfully on postoperative day 5.
Discussion:
Techniques for the treatment of symptomatic splenic cysts range from total splenectomy to cyst fenestration and placement of the omentum in the splenic defect. The use of radiofrequency ablation has been traditionally used for hepatic parenchymal transection but seems equally suited for the partial splenectomy. This technology, and the addition of hemostatic sponges, seems to provide excellent results in minimizing blood loss, intraoperatively and postoperatively, during the laparoscopic partial splenectomy; however, randomized, prospective trials will be necessary to see if they will be superior to traditional techniques.
