[Laparoscopic splenectomy for a massive splenomegaly using a transcatheter technique].

Laparoscopic splenectomy can be performed more safely today, and therefore it is becoming the first-choice technique for splenectomy when the spleen is of normal size. However, for massive splenomegaly there have been few reports of the use of this technique and its safety has not been confirmed. We performed laparoscopic splenectomy for massive splenomegaly with transarterial embolization of the splenic artery before surgery. A 37-year-old man underwent splenectomy due to the lack of effect of an approximately 4-month course of chemotherapy for chronic myeloid leukemia whose spleen was over 20 cm in length. Before surgery, splenic artery embolization was performed to prevent intraoperative bleeding and to debulk the spleen. Under general anesthesia the patient was positioned in the lateral decubitus position lying on the right side. There was no bleeding from the capsule of the spleen throughout the procedure and no intraoperative complications occurred. Blood loss was 100 ml, and the weight of the resected spleen was 1,100 g. The postoperative course was uneventful. We conclude that laparoscopic splenectomy is safe and feasible in cases of splenomegaly, when combined with preoperative embolization of the splenic artery.