Wandering Spleen is characterized by laxity or absence of the normal ligamentus attachments to the spleen. The sole attachment tends to be the vascular pedicle to the splenic hilum. Often discovered in childhood, it can also be detected in young adults. It is a rare condition with less than 500 cases reported in the world literature. The presentation can be an asymptomatic mass, an incidental finding on radiographic imaging, or a catastrophic presentation such as torsion or rupture. Computerized Volumetric Analysis Systems (CVAS) is a set of processes and tools that allow the surgeon to turn 2D radiographic images into 3D virtual models. This allows surgeons to visualize the surgical anatomy from any angle they may choose. The advantage of this preoperative virtual fly-through and virtual dissection is that it gives the surgeon a clear concept of the relation of structures that they will encounter during the procedure. This 3D imaging more closely correlates with the videoscopic imaging data than with 2D imaging that is traditionally used for operative planning. We present the case of an 18 year patient who underwent laparoscopic splenectomy for wandering spleen. The surgery was completed in 78 minutes with a 10cc blood loss and the spleen was removed through a 3 centimeter umbilical crease incision. The patient was ready for discharge on the 2nd post operative day. The degree of uncertainty associated with wandering spleen requires a studied surgical plan which is essential to safe and efficient laparoscopic procedures. CVAS provides a means to augment planning, thus diminishing the preoperative ambiguity, clarifying anatomic relationships and increasing the surgeon’s confidence. Figure 1: CVAS image of wandering spleen.
Program Number: P398