Laparoscopic splenectomy is widely accepted as a preferred surgical technique. Single port laparoscopic surgery further improves cosmesis, pain control and recovery compared to standard multi-port laparoscopy.
We report on a single port accessory splenectomy in patient with symptomatic recurrence of autoimmune hemolytic anemia after prior splenectomy more that 30 years ago. Patient was maintained on prednisone 30 mg daily preoperatively. Preoperative imaging localized accessory spleen to left upper quadrant area. With the use of SILS™ Port (Covidien) accessory spleen was identified in splenic fossa and removed. The later represented globular mass of 35 grams, 4.6 x 4.3 cm in diameter. Procedure lasted 80 minutes. Estimated blood loss was 30 ml. Postoperatively patient did well and was discharged on postoperative day three requiring only four Lortab tablets during hospital stay. During follow up patient is doing well, currently off steroids with hematocrit stabilized at 34 per cent.
We believe that single port surgery is an acceptable technique of splenectomy for such challenging problem as treatment failure due to retained accessory spleen. Preoperative imaging is critical for localization and operative planning.
Program Number: P526