Related Experiment Video
Updated: May 29, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
Laparoscopic splenectomy: outcome and efficacy for massive and supramassive spleens
Vadim P Koshenkov1, Zoltán H Németh, Mitchel S Carter
1Department of Surgery, Morristown Memorial Hospital-Atlantic Health, Morristown, NJ, USA. vadimkoshenkov@yahoo.com
Background:
Massive and supramassive splenomegaly are relative contraindications to pure laparoscopic splenectomy (LS).
Methods:
A retrospective review of adult patients was conducted for splenectomy occurring from 1999 to 2009. Massive and supramassive spleens were defined as craniocaudad length ≥ 17 cm or weight ≥ 600 g and craniocaudad length ≥ 22 cm or weight ≥ 1,600 g, respectively.
Results:
LS was done for 22 and open splenectomy for 21 patients, of which 12 and 14 were supramassive. Spleen weight and craniocaudad length were comparable. LS was associated with lower blood loss (308 vs 400 mL, P = .24), shorter length of stay (3 vs 4.5 days, P = .054), and similar morbidity (17% vs 14%). Two reoperations and 1 death occurred with open splenectomy. Operative times were longer for LS (195 vs 105 min, P = .008), while the conversion rate was 25%.
Conclusions:
In cases of massive and supramassive splenomegaly, better outcomes are accomplished with LS than open splenectomy, and are comparable to hand-assisted LS.