Fujioka Shuichi, Yoshida Kazuhiko, Okamoto Tomoyoshi, Yanaga Katsuhiko
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
Int Surg. 2013 Oct-Dec;98(4):385-7. doi: 10.9738/INTSURG-D-13-00035.1.
Laparoscopic splenectomy (LS) has been accepted as a safe and effective procedure as compared with open splenectomy. Recently, there have been a few reports on the LigaSure vessel sealing system as an alternative hemostasis to clip ligation. Here we report the experience of LS using an alternative energy device, Harmonic Scalpel laparoscopic coagulating shears (LCS). Preliminary experience of LS with LCS for a patient with idiopathic thrombocytopenic purpura (ITP) is reported. Generally, two-step sealing with LCS was used for vessels of the splenic pedicle approximately 5 mm in diameter without using the Endo-GIA stapler. Operative time was 93 minutes, and blood loss was 40 mL. The patient was discharged on the third postoperative day with no intraoperative or postoperative complications. The LS with LCS was performed safely using two-step sealing. Further experience is necessary to verify the safety of this procedure.
与开放性脾切除术相比，腹腔镜脾切除术（LS）已被公认为是一种安全有效的手术方法。最近，有一些关于LigaSure血管闭合系统作为夹闭结扎替代止血方法的报道。在此，我们报告使用一种替代能量装置——超声刀腹腔镜凝固剪（LCS）进行LS的经验。报道了使用LCS对一名特发性血小板减少性紫癜（ITP）患者进行LS的初步经验。一般来说，对于直径约5mm的脾蒂血管，在不使用Endo-GIA吻合器的情况下，采用LCS两步闭合。手术时间为93分钟，失血量为40mL。患者术后第三天出院，无术中或术后并发症。使用两步闭合安全地进行了LCS辅助的LS。需要进一步的经验来验证该手术的安全性。
