A New Technique for Laparoscopic Splenectomy in Children with Massive Splenomegaly

Abstract

ABSTRACT Splenectomy is indicated in several hematologic disorders, and it can be particularly challenging in children with sickle cell disease (SSD), splenomegaly, and recurrent sequestration. The authors report a new technique for laparoscopic splenectomy in children with hypersplenism and splenomegaly using an intracorporeal morcellator. With this technique, splenectomy is accomplished by sequential coring of splenic tissue, which allows for safe and complete laparoscopic removal of very large spleens, even in small children. It provides expedient recovery and minimal postoperative pain and scarring. This new approach should enable surgeons to perform laparoscopic splenectomy even in patients with massive splenomegaly, eliminating the need for large and cumbersome intracorporeal bags or the creation of additional incisions to remove the spleen.