Laparoscopic splenectomy:the latest technical evaluation
Laparoscopic splenectomy:the latest technical evaluation作者机构：Department of General Surgery The First Affiliated Hospital of Sun Yat-sen University Guangzhou 510080 Guangdong Province China. tommyt@***
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2003年第9卷第5期
页 面：1086-1089页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
主 题：腹腔镜脾切除术 CO2气腹 全身麻醉 脾功能失常 安全性 腹部外科
摘 要：AIM: To introduce our latest innovation on technical manipulation of laparoscopic ***: Under general anesthesia and carbon dioxide (CO2) pneumoperitoneum, 86 cases of laparoscopic splenectomy (LS) were performed. The patients were placed in three different operative positions: 7 cases in the lithotomic position, 31 cases in the right recumbent position and 48cases in the right lateral position. An ultrasonic scissors was used to dissect the pancreaticosplenic ligament, the splenocolicum ligament, lienorenal ligament and the lienophrenic ligament, respectively. Lastly, the gastrosplenic ligament and short gastric vessels were dissected. The splenic artery and vein were resected at splenic hilum with EndoGIA. The impact of different operative positions, spleen size and other events during the operation were ***: The laparoscopic splenectomy was successfully performed on all 86 patients from August 1997 to August 2002. No operative complications, such as peritoneal cavity infection, massive bleeding after operation and adjacent organs injured were observed. There was no death related to the operation. The study showed that different operative positions could significantly influence the manipulation of LS. The right lateral position had more advantages than the lithotomic position and the right recumbent position in ***: Most cases of LS could be accomplishedsuccessfully when patients are placed in the right lateral position. The right lateral position has more advantages than the conventional supine approach by providing a more direct view of the splenic hilum as well as other important anatomies. Regardless of operation positions, the major axis of spleen exceeding 15 cm by B-ultrasound in vitro will surely increase the difficulties of LS and therefore prolong the duration of operation. LS is a safe and feasible modality for splenectomy.
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