Barbaros U, Dinccag A, Deveci U, Akyuz M, Tükenmez M, Erbil Y, Mercan S
Istanbul University, Istanbul Medical School, Department of General Surgery, Capa, Istanbul, Turkey.
Acta Chir Belg. 2007 Mar-Apr;107(2):162-5.
Main causes of conversion to open surgery are uncontrolled bleeding from splenic hilum and capsular injury of spleen during laparoscopic splenectomy (LS). We present the use of LigaSure in laparoscopic splenectomy for hemostasis.
MATERIAL & METHOD: Between January 2005 and May 2006, LS was performed in a total of 29 patients (6 male and 23 female) with a mean age of 35.44 +/- 13.63. Indications for splenectomy were idiopathic thrombocytopenic purpura (ITP) in 20 patients, thrombotic thrombocytopenic purpura (TTP) in 2, hereditary spherocytosis (HS) in 3, lymphangioma in 2, hodgkin lymphoma in 1 and splenic cyst in one patient. LS was performed in the right semilateral position with three 10 mm trocars. LigaSure was used in dissection and division of splenic ligaments and hilar vascular structures.
Conversion to open surgery was necessary in one patient due to peroperative bleeding. The mean duration of the operation was 71.3 +/- 19.8 minutes and the estimated blood loss was 85 +/- 23 ml. The diameter and the weight of the spleen were 10.7 +/- 2.68 cm and 250 +/- 90 g, respectively. There was no mortality. Postoperative complications included pancreatic fistula, trocar site infection and deep venous thrombosis that were encountered in three patients. These were managed without morbidity. The overall complication rate was 10.3% (n = 3). The mean duration of postoperative hospital stay was 2.86 +/- 1.59 days.
LigaSureTM use in LS had easy application, provided sufficient hemostasis, and shortened the operative time.
在腹腔镜脾切除术（LS）中，转为开放手术的主要原因是脾门处无法控制的出血和脾脏包膜损伤。我们介绍了LigaSure在腹腔镜脾切除术中用于止血的情况。
2005年1月至2006年5月期间，共对29例患者（6例男性，23例女性）进行了LS，平均年龄为35.44±13.63岁。脾切除的适应证包括：20例特发性血小板减少性紫癜（ITP）、2例血栓性血小板减少性紫癜（TTP）、3例遗传性球形红细胞增多症（HS）、2例淋巴管瘤、1例霍奇金淋巴瘤和1例脾囊肿。LS在右侧半卧位采用三个10毫米套管针进行。LigaSure用于脾韧带和脾门血管结构的解剖和分离。
1例患者因术中出血需要转为开放手术。平均手术时间为71.3±19.8分钟，估计失血量为85±23毫升。脾脏的直径和重量分别为10.7±2.68厘米和250±90克。无死亡病例。术后并发症包括3例患者出现的胰瘘、套管针部位感染和深静脉血栓形成。这些并发症经处理后未出现不良后果。总体并发症发生率为10.3%（n = 3）。术后平均住院时间为2.86±1.59天。
在LS中使用LigaSureTM操作简便，能提供充分的止血效果，并缩短了手术时间。
