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Elective Laparoscopic Splenectomy: Personal Experience and Literature Review

Department ofDigestive Surgery, St-Luc UniUersi y Hospital, Louvain Medical School, Brussels, Belgium

J. Etienne, MD

Department ofDigestive Surgery, St-Luc UniUersi y Hospital, Louvain Medical School, Brussels, Belgium

B. Lengele, MD

Department ofDigestive Surgery, St-Luc UniUersi y Hospital, Louvain Medical School, Brussels, Belgium

P.J. Kestens, MD

Department ofDigestive Surgery, St-Luc UniUersi y Hospital, Louvain Medical School, Brussels, Belgium

Laparoscopic splenectomy has become an attractive treatment for patients with selected hematologic disorders. Almost 200 observations have been reported. The rate of conversion to laparotomy is 10% to 15%, and the complication rate is between 0% and 30%. Adequate selection of patients, preoperative administration of intravenous immunoglobulin in patients with idiopathic thrombocytopenic purpura, meticulous surgical technique, and careful preoperative and intraoperative search for accessory spleen are critical factors for success in these patients. The procedure should be confined to expert laparoscopic surgeons with considerable experience in the management of hematologic diseases.

Key Words: Splenectomy • idiopathic thrombocytopenia • spherocytosis • accessory spleen.

Surgical Innovation, Vol. 3, No. 1, 34-43 (1996)
DOI: 10.1177/155335069600300107


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