Spleen Conditions
A splenectomy (removal of the spleen) is performed in cases where the patient is suffering from certain types of leukemia or blood disease.
Experience and Results
Between January 1992 and septembre 1995, 31 consecutive patients underwent regular laparoscopic splenectomy by the first author.
Length of the operation ranged from 90 to 360 min (median 180). Laparoscopic splenectomy was successfully performed in 24 cases. Two conversions to laparotomy were necessary because of continuous uncontrollable bleeding caused by parenchymal injury, one in a case of significant splenomegaly, and one in a patient with cavernous hemangioma. In three other cases injury to a sizeable blood vessel was controlled laparoscopically by initial compression with adjacent tissue, followed by clip ligation. Blood loss ranged between 50 ml and 1500 ml (median 200 ml). Accessory spleens were searched for systematically, found in two patients and removed succesfully. One was located in the splenocolic ligament and one in the omental bursa. In 27 patients postoperative course was uneventful. Two surgical complications occurred : one evisceration of an omental fringe and one left pneumothorax for which a chest tube had to be placed. There were two medical complications : confusion and agitation in one patient and bronchitis in another. Bowel sounds were present as of the first postoperative day in all patients. Postoperative stay in this group ranged between 2 and 16 days (median 3 days).
