Sickle cell disease, anesthesia, and sammy sickler

Minimally Invasive Splenectomy for splenomegaly by traditional technique:A comparative study with conventional laparoscopic Splenectomy

“…The ordinary post-operative follow-up for splenectomized patients, is not concerned here, because there is no any advantage over classical conventional splenectomy,in regard to infection rate, opportunistic post-splenectomy sepsis(OPSI),abnormal blood changes and post-splenectomy events (21,22,23,24). The dose of narcotics were significantly lower in minimally invasive group than classical traditional group, because the size of incisions and lower tissue damage directly proportional to narcotic analgesic requirement, which is a well known physiological fact (19,20). The hospital stay was longer in cases who underwent splenectomy for malignant disease (Lymphoma and Chronic Myeloid Leukemia) in both groups, this is related to the complex situation of the original problem (14,15,16,17) The procedure of Minimal invasive splenectomy is as follows, in which the experience of the surgeon will be the last factor in the success of the procedure: On the top of the list is the position of the patient ,in which the head of the bed should be elevated(anti-trendelenburg),a sand bag or bridge under the left hypochondrium, crossing the midline ,turning the patient to the right and counteracting this position by elevation of the legs., A proper anesthesia and full relaxation is the secrete of success in this procedure, Using head light will be very helpful with long narrow Diver's retractors, Experience of the surgeon.…”