Laparoscopic / Minimally invasive splenectomy

Splenectomy was a common operation in the past. The indication used to be splenic trauma, haemolytic anemia, idiopathic thrombocytopenic purpura (ITP), stomach / pancreas / colon cancer with splenic involvement, chronic pancreatitis with splenic involvement (pseudo cyst or varices) and rarely for primary splenic problems like splenic tumor. However over time old indications like ITP have reduced due to better medications and primary splenic problems & HA are the main indications for splenectomy now. Most of these spleens are very large in size compared to an ITP spleen making them suitable for a laparoscopic surgery only in the hands of experienced laparoscopic surgeon. We would like to showcase one such patient with splenic tumor who recently underwent a laparoscopic splenectomy with us.

A 35 year old lady presented to us with abdominal pain. USG / CT / MRI showed a large 8 cm vascular tumor in the spleen. A laparoscopic splenectomy was done and patient was discharged by 5th postoperative day.

Laparoscopic splenectomy is ideal in small sized spleen. However can be done even for large spleen as in our case depending upon surgeon experience.

Advantages of laparoscopic surgery

• Small incisions
• No cutting of muscles
• Less risk of incisional hernia
• Less pain
• Quicker mobilisation
• Short hospital stay

Disadvantages / limitations

• May need longer operative time.
• Not suitable for all patients
• Does require at least a small incision to remove the specimen organs.
• Requires high level of laparoscopic surgical skills.