Izquierdo Cristina, García-Picazo Alberto, Rodríguez Juan Pablo, Navarro Anna, Donisi Greta, Luque Eduardo, Ielpo Benedetto, Burdío Fernando, Sánchez-Velázquez Patricia
Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, University Hospital del Mar-IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Universitat Pompeu-Fabra, Barcelona, Spain.
Ann Surg Oncol. 2025 Feb;32(2):1232-1235. doi: 10.1245/s10434-024-16549-2. Epub 2024 Nov 22.
Laparoscopic subtotal splenectomy (LSS) is a procedure that helps avoid the consequences of asplenia. Given the spleen's importance and functionality, there may be specific indications and patient conditions in which partial splenectomy is beneficial. This case report aims to clarify the indications for LSS and outline the surgical technique.
This multimedia article provides a comprehensive overview of the surgical procedure, emphasizing key steps to avoid postoperative bleeding and complications.
The patient was hospitalized for 3 days without any complications observed. Postoperative hemoglobin levels were 11.2 g/dL, with no signs of anemia. The patient was discharged with a follow-up visit after 2 weeks, showing no evidence of postoperative complications. The anatomopathological study revealed a nodular area with extensive tumoral necrosis.
LSS is a safe surgical option that might help to mitigate the consequences of total splenectomy. Innovative technology in hemostasis, such as COOLINGBIS (a monopolar electrosurgical electrode designed for hemostatic sealing and coagulation) can help manage this risk. Identifying the vascular pedicle via computed tomography scan is crucial to prevent unexpected bleeding.
In selected cases, LSS is a feasible and safe procedure when performed with appropriate laparoscopic equipment and by experienced surgeons.
腹腔镜脾次全切除术(LSS)是一种有助于避免无脾后果的手术。鉴于脾脏的重要性和功能,在某些特定的适应症和患者情况下,部分脾切除术可能是有益的。本病例报告旨在阐明LSS的适应症并概述手术技术。
这篇多媒体文章全面概述了该手术过程,强调了避免术后出血和并发症的关键步骤。
患者住院3天,未观察到任何并发症。术后血红蛋白水平为11.2 g/dL,无贫血迹象。患者在2周后出院并进行随访,未发现术后并发症的迹象。解剖病理学研究显示一个有广泛肿瘤坏死的结节区域。
LSS是一种安全的手术选择,可能有助于减轻全脾切除术的后果。止血方面的创新技术,如COOLINGBIS(一种用于止血密封和凝血的单极电外科电极)有助于管理这种风险。通过计算机断层扫描识别血管蒂对于预防意外出血至关重要。
在特定病例中,当使用适当的腹腔镜设备并由经验丰富的外科医生进行操作时,LSS是一种可行且安全的手术。