Single incision laparoscopic splenectomy with hilar dissection for massive splenomegaly (with video)

Abstract

Splenectomy;Laparoscopy;Single incision;Hilar dissection;SplenomegalyThe first laparoscopic splenectomy was performed in 1992 [1]. This approach is now thetechnique of choice for splenectomy. Single trocar surgery has been developed since theend ofthe1990s. Several teams have described advantages single trocar splenec-tomy [2,3]. However, most of these studies have been on relatively small size spleens withroutine stapling ofthesplenic hilum. This video shows technique single incisionsplenectomy withsplenic hilar dissection in a patient massive splenomegaly.A 16-year-old girl with hereditary spherocytosis requiring blood transfusions forsymptomatic anemia was referred for splenectomy. Abdominal MRI showed massivesplenectomy, measuring 21cm in the longitudinal axis.The patient was positioned supine, legs apart with the operator standing between thepatient’s legs while freeing the lower pole of the spleen, and then moving to the patient’sright side for the rest of the operation. A 2cm incision was made at the level of theumbilicus to insert a four port single trocar (Quadriport