Laparoscopic Partial Splenectomy with Linear Cutting Stapler-Assisted Parenchymal Transection: a Novel Technique

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Laparoscopic partial splenectomy (LPS) is crucial for resecting benign splenic lesions while preserving spleen function.
• Hemorrhage control during splenic parenchymal transection is a significant surgical challenge.
• Existing methods like bipolar electrothermal devices and microwave ablation have limitations.

Purpose of the Study:

• To introduce and evaluate a novel technique for LPS integrating ultrasonic dissection with linear stapling.
• To improve safety and efficiency in laparoscopic partial splenectomy by addressing hemorrhage control.

Main Methods:

• A 66-year-old female patient with a large splenic cyst underwent evaluation with CT and MRI.
• The LPS protocol involved dividing splenic ligaments/vessels, identifying segmental vessels, pre-dissection, and combined ultrasonic dissection with sequential stapling.
• Hemlock clips were used for vessel division.

Main Results:

• The procedure was successfully completed in 145 minutes with minimal blood loss (50 mL).
• No intraoperative complications or transfusions were needed.
• The patient was discharged on postoperative day 4 with no complications; pathology confirmed a benign mesothelial cyst.

Conclusions:

• Stapler-assisted LPS enhances safety and efficiency by minimizing intraoperative hemorrhage.
• This technique streamlines the parenchymal transection process during laparoscopic partial splenectomy.
• The integrated approach offers a promising advancement for spleen-preserving surgery.