Abstract
Thalassemia is one of the most common monogenic disorders in India. Approximately 7500- 12,000 babies with β-thalassemia major are born every year in the country. [13] Because of the magnitude of the disease and health-care burden it poses, it has been covered as part of various National Programs by the Government of India. Children with features of hypersplenism and increased packed red blood cell (PRBC) transfusion requirement are referred to the pediatric surgical unit for splenectomy. Open splenectomy is performed with utmost care and only when clearly indicated. Regular follow-up assessments are done following splenectomy.
 The present study was planned in Department of General surgery, Government Doon Medical College, Dehradun, Uttarakhand, India. The study was conducted from March 2018 to June 2019. In the present study 20 patients diagnosed with the thalassemia in which the splenectomy was suggested. A single team were operated all the patients which headed by the second author. Hypersplenism, increased requirement of blood transfusion, haemosiderosis and abdominal discomfort due to splenomegaly revealed as indications for splenectomy. Preoperative blood transfusion were done to correct Hb >10 gm% in all patients. Immunization was done 3 weeks prior to surgery with polyvalent pneumococcal, hepatitis B and H. influenzae B vaccines for all patients.
 The data generated from the present study concludes that Laparoscopic splenectomy revealed to be feasible and safe procedure to β thalassemia patients with splenomegaly. Pfannenstiel incision for specimen extraction is significantly decrease time, with low morbidity and offer better cosmetic results. The operative time in laparoscopic splenectomy is still longer than the open splenectomy but it decrease with time due to increased experience.
 Keywords: Laparoscopic splenectomy, Thalassemia, Pfannenstiel incision, etc.
Highlights
The spleen, originally called the organum plenum mysterii by Galen, has long been an important organ for surgeons
Children with features of hypersplenism and increased packed red blood cell (PRBC) transfusion requirement are referred to the pediatric surgical unit for splenectomy
The data generated from the present study concludes that Laparoscopic splenectomy revealed to be feasible and safe procedure to β thalassemia patients with splenomegaly
Summary
The spleen, originally called the organum plenum mysterii by Galen, has long been an important organ for surgeons. With the advent of minimally invasive techniques, laparoscopic splenectomy has become a standard procedure for elective removal of the spleen for most indications. Laparoscopic splenectomy is indicated for various benign hematologic diseases, malignant hematologic diseases, secondary hypersplenism, and other anatomic disorders of the spleen. The most common benign hematologic disease treated with laparoscopic splenectomy is immune thrombocytopenic purpura (ITP), and the procedure is recommended when medical therapy, including steroids and intravenous gammaglobulin, fails or long-term steroids are needed. Laparoscopic splenectomy can be warranted in other benign conditions, including other types of thrombotic purpura, hereditary spherocytosis, major and intermediate thalassemia with secondary hypersplenism or severe anemia, sickle cell disease, and refractory autoimmune hemolytic anemia
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