Mark L Kovler, MD1, Seth D Goldstein, MD, MPhil2, Daniel S Rhee, MD, MPH3. 1Johns Hopkins Hospital, 2Lurie Children’s Hospital, 3Johns Hopkins Children’s Center
Introduction: Partial splenectomy has emerged as a surgical option for children with benign splenic tumors. The goal of complete resection while preserving splenic function is logical. However, laparoscopic partial splenectomy remains technically challenging. We present a novel technique for laparoscopic partial splenectomy with evisceration resection strategy.
Presentation of case: A 5 year-old female presented to our surgical clinic for evaluation of an upper pole splenic mass discovered during a work up for abdominal pain. Imaging suggested the mass was a benign tumor. Given her persistent abdominal pain and the benign features, we performed a laparoscopic partial splenectomy with evisceration resection strategy.
Video Content: The patient was positioned supine with a bump placed under the left side. An umbilical port was placed and inspection of the abdomen revealed splenomegaly. Left upper quadrant and epigastric ports were placed. The short gastric vessels were divided. Hilar inspection identified a superior branch of the splenic vasculature, which was divided using an endoscopic stapler. The remaining attachments were divided and complete splenic mobilization was accomplished. The spleen was eviscerated through a transverse mini-laparotomy in the left upper quadrant. Extracorporeal resection of the tumor was performed. After fascial closure, the remnant was inspected laparoscopically for proper anatomic position and hemostasis.
Outcome: Length of stay was two days. The patient has had sustained resolution of preoperative abdominal pain. Pathology demonstrated a benign hamartoma.
Conclusion: Evisceration resection strategy is a safe and feasible technique for performing laparoscopic partial splenectomy in children.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93386
Program Number: V334
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop