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Updated: May 28, 2026
Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Use of Nathanson retractor during laparoscopic splenectomy for supermassive spleens
Deepraj Bhandarkar1, Avinash Katara, Gaurav Mittal
1Department of Minimal Access Surgery, Hinduja Hospital, Veer Savarkar Marg, Mahim, Mumbai, India. deeprajbhandarkar@hotmail.com
Background:
Although feasibility of laparoscopic splenectomy for supermassive spleens has been described, obtaining uniform and uninterrupted retraction of a heavy spleen to ensure safe hilar dissection is challenging. We describe a technique of retraction of supermassive spleens using a Nathanson retractor.
Methods:
This technique was used in 4 patients, and the demographic data as well as data related to the surgery were retrospectively collected.
Results:
The spleens weighed between 2.5 and 3.5 kg. The median operative time was 190 minutes (155-220 min) and the median intraoperative blood loss was 870 mL (600-1230 mL). The postoperative hospital stay ranged from 3 to 5 days.
Conclusions:
A Nathanson retractor provides sustained retraction of a supermassive spleen during laparoscopic splenectomy and this technique should be considered a useful adjunct to the armamentarium of surgeons undertaking these challenging procedures.