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Updated: Apr 28, 2026
Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Single-incision laparoscopic splenectomy for massive splenomegaly combining gastroesophageal devascularization using
Jun Xu1, Lei Zhao, Zhifei Wang
1*Department of General Surgery, the First Affiliated Hospital of Harbin Medical University †Department of General Surgery, the Fourth Hospital of Harbin Medical University, Nan Gang District, Harbin ‡Department of HPB Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Xiacheng District, Hangzhou, China.
Single-incision laparoscopic surgery (SILS) for massive splenomegaly with gastroesophageal devascularization is feasible. Experienced surgeons can modify techniques for this complex procedure, achieving satisfactory outcomes.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Hepatology
Background:
- Single-incision laparoscopic surgery (SILS) for massive splenomegaly and gastroesophageal devascularization is not well-documented.
- Massive splenomegaly often co-occurs with liver cirrhosis, portal hypertension, and hypersplenism.
Purpose of the Study:
- To evaluate the feasibility and outcomes of SILS for massive splenomegaly, with or without concurrent gastroesophageal devascularization.
- To present surgical techniques for SILS in complex cases.
Main Methods:
- Six male patients with liver cirrhosis and massive splenomegaly underwent SILS.
- Four patients had combined gastroesophageal devascularization using a Ligasure device.
- A single umbilical incision was used for port placement and specimen retrieval.
Main Results:
- The procedure was technically feasible with satisfactory surgical outcomes.
- One patient required conversion to hand-assisted laparoscopy due to bleeding.
- The mean operation time was 265 minutes with 300 mL blood loss.
Conclusions:
- SILS combining gastroesophageal devascularization for massive splenomegaly is technically feasible for experienced laparoscopic surgeons.
- Modifications in technique and procedural sequencing are necessary to overcome instrument movement constraints.
- This approach offers a minimally invasive option for selected patients.
