Subtotal splenectomy appears to control hemolysis while maintaining splenic function. The laparoscopic approach is safe and effective and should be considered the procedure of choice in hereditary microspherocytosis. Laparoscopic subtotal splenectomy presents an advantage over open subtotal splenectomy, resulting in decreased blood loss, shorter hospital stay, no conversions, fewer operative and postoperative complications, and excellent remission rates. On the basis of our experience, the preservation of the lower pole of the spleen seems to be a first-line option for the optimal evaluation of the residual splenic mass.
The paper by Sanjeev Dutta et al. [1] about the laparoscopic approach to partial splenectomy in children with hereditary spherocytosis states that they have developed a novel laparoscopic partial splenectomy technique that combines the benefits of partial splenectomy with those of a laparoscopic approach. This technique, however, is not new, as erroneously stated by the authors. The technique was first published in 2003 [2] (the paper, with an English abstract, is listed by Medline). Subsequent results were presented in 2005 and published in your journal in 2006 [3]. Our group has utilized this technique for several years and has performed laparoscopic subtotal splenectomies between
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