Spleen preserving laparoscopic resection of splenic artery aneurysm

Francesco Stipa, MD, PhD, FACS, Emanuele Soricelli, MD, Ettore Santini, MD, P Paolantoni, MD, Francis Milton Reedy, MD. Department of Surgery, Colorectal and Vascular Surgical Units. San Giovanni Addolorata Hospital – Rome.

 Purpose: The splenic artery is the most common visceral artery to become aneurysmal. Indications for the treatment of splenic artery aneurysms include symptomatic and/or enlarging aneurysms, aneurysms larger than 1.5 cm and aneurysms in women who are pregnant or of childbearing age. The treatment is not well standardized and could consist of radiological embolization or resection with or without splenectomy via either a laparotomy or laparoscopy.

Methods: The video shows a laparoscopic resection of a splenic artery aneurysm, with preservation of the spleen, in a 48 years old healthy woman. The procedure was performed through an anterior approach. Once the gastroepiploic ligament was divided, the aneurysm was dissected free from the splenic vein. The splenic artery was isolated proximally and distally to the aneurysm and resected with a linear stapler. Post-operative course was uneventful. CT-arteriography performed one week and six months after surgery showed hypoperfusion of the spleen with areas of hypotrophy and regeneneration, with blood flow coming from left gastric and superior mesenteric arteries collateral branches.

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