Background: Delaitre and Maignien performed the first successful laparoscopic splenectomy in
1991. After that, laparoscopic splenectomy has become one of the most frequently
performed laparoscopic solid organ procedures. Aim: To demonstrate the surgical techique of laparoscopic splenetomy with reduced
portals. Methods: A reduce port laparoscopic splenectomy was performed by using a 10 mm and two 5 mm
trocars. To entered the abdomen a trans-umbilical open technique was done and a 10
mm trocar was placed. A subcostal 5 mm trocar was placed under direct vision at
the level of the anterior axillary line and another 5 mm port was inserted at the
mid-epigastric region. Once it was completely dissected and freed from all of its
attachments the hilum, splenic artery and vein, was clipped with hem-o-lock and
divided with scissors. Then an endobag was used to retrieve the spleen after being
morcellated trough the umbilical incision. Results: This technique was used in a 15 years old female with epigastric and left upper
quadrant pain. An abdominal ultrasound demonstrated a giant cyst located in the
spleen. Laboratory tests findings were normal. The CT scan was also done, and
showed a giant cyst, which squeeze the stomach. The patient tolerated well the
procedure, with an unremarkable postoperative. She was discharge home 72 h after
the surgery. Conclusion: The use of reduce port minimizes abdominal trauma and has the hypothetical
advantages of shorter postoperative stay, greater pain control, and better
cosmesis. Laparoscopic splenectomy for giant cysts by using reduce port trocars is
safe and feasible and less invasive.
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