Reduce Port Laparoscopic Splenectomy for Giant Epitelial Cyst

Abstract

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.

Splenectomy in Patient with Splendid Cysts

“…Therapy with a surgical approach through laparotomy with splenectomy is the most indicated [13], although currently, for asymptomatic cases and presenting cysts smaller than two centimeters, which do not show calcifications or increased internal or collateral circulation, expectant management is accepted [14] Recent case studies indicate the advantages of video laparoscopy approach (VL) for performing the cyst crackling. This procedure has the purpose of allowing free drainage in the peritoneal cavity so that the fluid is reabsorbed.…”

Esplenectomia No Manejo Do Paciente Traumatizado

“…Uma vez que o baço e todos os seus anexos hilares estejam completamente dissecados, a artéria e a veia esplênica são ligadas com hemolocks e seccionados. Em seguida o baço é morcelado e através da incisão umbilical um endobag é usado para a retirada dos fragmentos (PALERMO et al, 2015).…”