Our Summary

This research paper presents a new method for removing the spleen through a minimally invasive surgical procedure, known as a laparoscopic splenectomy (LS). The procedure was carried out on 16 patients, utilizing general anesthesia and carbon dioxide to inflate the abdomen for better visibility.

Here’s an attempt to make the surgical steps more understandable:

  1. The fatty layer that covers the stomach (omental) was cut and pulled back to better see the pancreas.
  2. A root of blood vessels in the omentum was tied off, further exposing the pancreas.
  3. The outer layer of the pancreas was opened and lifted to better grasp the top edge of the pancreas.
  4. The blood vessels around the spleen were tied off and separated.
  5. Certain ligaments were cut using an ultrasound knife, and some thick blood vessels were clamped.
  6. This process exposed the area above the tail of the pancreas where the spleen connects.
  7. The spleen’s blood vessels were hung up with a silk suture for easy manipulation.
  8. These vessels were then cut using an ultrasound knife, and the portal vessels were isolated and cut.
  9. Additional ligaments were also cut.
  10. The spleen was put into a bag, and the surgical port was enlarged slightly.
  11. Finally, the spleen was cut into smaller pieces for removal.

The surgeries took place between March 2015 and January 2016. Out of 16 surgeries, 15 were successful, while one had to be converted to an open surgery. No patients had bleeding or infections in the abdomen after the surgery. One patient had air trapped under the skin, and another had a wound infection. There were no deaths.

The study concludes that this method of exposing the area behind the tail of the pancreas is a safe and simple method for spleen removal.

FAQs

  1. What is the new approach to laparoscopic splenectomy introduced in this study?
  2. What were the results and complications of the new laparoscopic splenectomy approach?
  3. How is the spleen removed in the new laparoscopic splenectomy approach?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to avoid heavy lifting or strenuous activity for a certain period of time after the surgery to allow for proper healing and to prevent any complications. It is important to follow the doctor’s instructions carefully to ensure a smooth recovery process.

Suitable For

Patients who are typically recommended splenectomy include those with conditions such as:

  1. Hematologic disorders, such as idiopathic thrombocytopenic purpura (ITP), hereditary spherocytosis, and autoimmune hemolytic anemia.
  2. Certain types of cancers, such as lymphomas and some types of leukemia.
  3. Trauma to the spleen, such as splenic rupture.
  4. Enlarged spleen (splenomegaly) due to various underlying causes.
  5. Certain infections, such as splenic abscess or certain parasitic infections.
  6. Non-functioning or painful spleen due to conditions like sickle cell disease or hereditary spherocytosis.

Timeline

Before splenectomy:

  • Patient presents with symptoms such as anemia, fatigue, frequent infections, and abdominal pain
  • Patient undergoes diagnostic tests such as blood tests, imaging scans, and possibly a bone marrow biopsy to confirm the need for splenectomy
  • Patient may receive vaccinations to prevent infections post-splenectomy

After splenectomy:

  • Patient undergoes laparoscopic splenectomy procedure as described above
  • Patient is monitored in the hospital for a few days for any complications such as bleeding or infection
  • Patient may experience some pain and discomfort post-surgery
  • Patient is discharged from the hospital and instructed on how to care for their incision site and prevent infections
  • Patient may need to take antibiotics and receive regular vaccinations to prevent infections due to the absence of a spleen

What to Ask Your Doctor

  1. What are the potential risks and complications of splenectomy?
  2. How will my immune system be affected after splenectomy?
  3. How long is the recovery period after splenectomy?
  4. Will I need any special vaccinations or medications after splenectomy?
  5. How will my diet need to change after splenectomy?
  6. Will I need any follow-up appointments or tests after the surgery?
  7. Are there any long-term effects or complications I should be aware of?
  8. How will my body compensate for the absence of a spleen?
  9. Are there any alternative treatment options to splenectomy?
  10. What is the success rate of laparoscopic splenectomy compared to traditional open surgery?

Reference

Authors: He QJ, Dai XM, Yu C, Yang SL. Journal: Clinics (Sao Paulo). 2018 Nov 29;73:e16536. doi: 10.6061/clinics/2018/e16-536. PMID: 30517277