Laparoscopic Resection of a Giant Splenic Artery Aneurysm

INTRODUCTION: Splenic artery aneurysm affects 0.1% of population. They are often an incidental radiological finding. A spontaneous rupture may be fatal. Intervention is indicated when they reach 2 cm in diameter, are symptomatic, increasing in size, in pregnant patients or in women of child-bearing age. Small splenic artery aneurysm under 4 cm could be treated with percutaneous embolization, however larger aneurysms may require surgery or combination of both treaments.
CASE REPORT: A 69 years old female with a 8.2 cm asymptomatic splenic artery aneurysm detected by ultrasound during follow-up of breast cancer. Her past medical history is also relevant for hypertension, open cholecystectomy and open appendectomy. A CT-scan confirmed the diagnosis. Because of the size of the aneurysm, an embolization of splenic artery was done 24 hours before surgery to ensure vascular control.
VIDEO PRESENTATION: The key steps showed in this video are:
– Patient and trocar positioning
– Exposure of aneurysm in lesser sac
– Identification and control of both splenic artery and vein
– Dissecting the aneurysm free from the pancreas
– Mobilization of spleen and completion of splenectomy
– Extraction of the intact specimen
CONCLUSION: The patient was discharged on postoperative day 4, without any complications. The laparoscopic approach of giant splenic artery aneurysm is safe, using preoperative percutaneous embolization of the aneurysm.

Session: Podium Video Presentation

Program Number: V053

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