Laparoscopic partial splenectomy with modified Warshaw method for severe traumatic splenic rupture: a case report

Area of Science:

• Trauma Surgery
• Surgical Innovation
• Abdominal Injury Management

Background:

• The spleen is frequently injured in abdominal trauma, often causing hemodynamic instability and necessitating surgery.
• While non-surgical interventions like interventional therapy are increasingly successful for splenic injuries, severe cases still require surgical management.
• Laparoscopic partial splenectomy offers a potential organ-sparing alternative for complex splenic trauma.

Purpose of the Study:

• To detail the surgical treatment of a grade IV splenic laceration involving the splenic hilum.
• To present a novel laparoscopic partial splenectomy technique for severe splenic injuries.
• To demonstrate the feasibility of spleen preservation in complex splenic trauma cases.

Main Methods:

• A 26-year-old male with a grade IV splenic laceration underwent laparoscopic partial splenectomy.
• Resection of the lower pole of the spleen, including ligation of its artery and vein branches.
• Preservation of splenic tissue through selective artery ligation and splenic vein reflux, avoiding total splenectomy.

Main Results:

• Successful laparoscopic partial splenectomy was performed for a complex splenic injury.
• The patient avoided a total splenectomy, preserving spleen function.
• The patient recovered well and was discharged after 10 days of hospitalization.

Conclusions:

• Laparoscopic partial splenectomy with artery resection and vein preservation is a viable surgical option for severe splenic injuries involving the hilum.
• This spleen-sparing technique offers an alternative to total splenectomy in select cases of severe splenic trauma.
• The presented method facilitates successful management of complex splenic lacerations while preserving organ function.