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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

Published on: November 15, 2024

Transvaginal Mini-Laparoscopic Splenectomy.

Mehmet Ali A Yagci¹, Cuneyt Kayaalp¹, Fatih Sumer¹

¹Surgery, Inonu University.

|November 7, 2015

Summary

This study presents a highly minimal invasive splenectomy using only two umbilical and one vaginal trocar. The transvaginal approach facilitated spleen removal without fragmentation, offering a new natural orifice surgery option.

Keywords:

laparoscopy natural orifice specimen extraction natural orifice surgery natural orifice transluminal endoscopic surgery splenectomy transvaginal

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Area of Science:

Minimally Invasive Surgery
Surgical Innovation
Gastroenterology

Background:

Immune thrombocytopenic purpura necessitates splenectomy.
Conventional splenectomy can involve significant invasiveness.
Developing less invasive surgical techniques is a priority.

Observation:

A novel splenectomy technique utilized two 5 mm umbilical trocars and one vaginal trocar.
The transvaginal port enabled spleen dissection and division using a vessel sealing system.
Spleen extraction was performed through the vagina in a bag, ensuring no fragmentation.

Findings:

The procedure resulted in a highly minimal invasive splenectomy with minimal blood loss (< 20 ml) and a 200-minute operating time.
The patient experienced an uneventful postoperative course, was discharged on day two, and required no analgesics.
Postoperative platelet counts increased significantly to 408,000 mm(3).

Implications:

This transvaginal approach represents a potentially feasible method for natural orifice splenectomy.
The technique allows for unfragmented spleen extraction, minimizing potential complications.
This advancement in minimally invasive surgery may offer benefits for patients requiring splenectomy.