Laparoscopic splenectomy using LigaSure in benign hematologic diseases.

Today laparoscopic splenectomy (LS) is considered the gold standard for the treatment of hematologic disorders of the spleen with the aid of advancements in laparoscopy technique and modern electrosurgical devices. LigaSure vessel sealing system permanently fuses vessels up to 7 mm in diameter by applying a precise amount of pressure and bipolar energy to the tissue. We performed 14 LSs (7 has autoimmune hemolytic anemia, 6 has idiopathic thrombocytopenic purpura, and 1 has hereditary spherocytosis) using LigaSure. The mean spleen weight was 247 g (range, 147 to 620) and the largest diameter of the spleen was 12.1 cm (range, 10 to 23). The average operative time was 84.7 minutes (range, 30 to 190) including combined laparoscopic cholecystectomy in 2 patients and transabdominal preperitoneal inguinal hernia repair in 1 patient. Conversion to open procedure was unnecessary in our series. Minor morbidity occurred in 2 patients; no perioperative hemorrhage or mortality was observed. The average postoperative hospital stay was 3.1 days (range, 2 to 8). LS is a safe and feasible procedure for patients with previous abdominal surgery; gallstones in association with hemolytic anemia can also be treated during LS. LigaSure vessel sealing system during LS is safe and cost-effective method and reduces operating time.