Aurelio Francisco Aranzana Gomez, Jara Hernandez Gutierrez, MD, Juan Malo Corral, Soledad Buitrago Sivianes. Hospital Virgen De La Salud, Toledo
Introduction: Currently, laparoscopic splenectomy is considered the technique of choice for benign hematological diseases in which exeresis of the spleen is indicated, this type of approach being controversial for the malignant diseases that affect this organ, since it is convenient to extract the piece surgical procedure for its AP study and usually involves large lesions.
Objective: To demonstrate the safety and efficacy of the laparoscopic approach in massive splenomegaly.
Material and Method: Clinical case of a young patient, studied by hematology due to massive splenomegaly (spleen of more than 20 cms.). It provides iconography and complementary explorations of interest.
Results: Semi-lateral and complete laparoscopic approach, 4 trocars, splenomegaly of more than 20 cm, opening of the gastroesplenic ligament, section (EndoGIA) of the splenic artery, to decrease spleen size, identification of the pancreatic tail, mechanical section of the splenic vein, mobilization and complete extraction of the part after enlarging the lateral trocar orifice, drainage placement, good postoperative course, discharge on the 3rd day. ECODOPPLER control the week that
demonstrates portal thrombosis that requires anticoagulation by hematology. Definitive AP: Splenic low grade B lymphoma. Asymptomatic and with resolution of portal thrombosis after 2 YEARS of follow-up.
Conclusions: In selected patients and experienced teams, the size of the spleen is not a contraindication for the laparoscopic approach with the advantages already known for this type of technique. We recommend performing a follow-up echo-doppler to rule out laparoscopic post-splenectomy portal thrombosis, given the proven incidence of this complication when, in addition, there are associated risk factors.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94728
Program Number: V305
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop