Laparoscopic Splenectomy in Children with Hematological Disorders: Preliminary Experience at the Children's Hospital of New Orleans

Liu, Donald C.; Meyers, Michael O.; Hill, Charles B.; Loe Jr., William A.
December 2000
American Surgeon;Dec2000, Vol. 66 Issue 12, p1168
Academic Journal
Minimally invasive surgery has recently gained acceptance as the surgical approach of choice for a variety of surgical disorders in children. Although traditional open surgery is still regarded as the standard approach for a splenectomy in children when necessary for hematologic disorders a few cases of successful laparoscopic splenectomy (LS) have been reported. We present our initial 11 cases of LS in children assessing surgical outcome. Eleven patients ages 2 through 15 years underwent LS between June of 1996 and July of 1999 at the Children's Hospital of New Orleans. Indications for surgery included idiopathic thrombocytopenic purpura, congenital spherocytosis, and hemolytic anemia. In all patients the diameter of the spleen was less than 15 cm. Surgical outcome was assessed according to the following parameters: operative time, postoperative length of stay, postoperative morbidity, and cosmetic results. Data were accumulated on the basis of retrospective chart review. LS was completed in all 11 patients. Postoperative morbidity was minimal and the median postoperative stay was 2.4 days (range 1-5). Mean operative time was 3 hours and 10 minutes (range 1.5-7 hours) with the last six procedures completed in an average of just over 2 hours. Intravenous analgesia was discontinued in <48 hours in all patients. Cosmetic results were judged excellent in all cases. We conclude that LS was safe in children with certain hematologic disorders. Adequate selection of patients, appropriate preoperative preparation of patients, meticulous surgical technique, and careful postoperative care were key factors in obtaining the same long-term results as with open surgery.


Related Articles

  • Mini-Laparoscopic Splenectomy. Backus, Charles L.; Park, Adrian E.; Matthews, Brent D.; Heniford, B. Todd // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct2000, Vol. 10 Issue 5, p259 

    Determines the adequacy and safety of invasive instruments in laparoscopic splenectomy. Indications for splenectomy; Application of electrocautery.

  • A comparison of laparoscopic versus open splenectomy in children. Beanes, Steven; Emil, Sherif // American Surgeon;Oct1995, Vol. 61 Issue 10, p908 

    Compares laparoscopic versus open splenectomy among children patients in Los Angeles, California. Mean operative time; Hospital stay; Interval before tolerating a regular diet; Postoperative narcotic dose.

  • The Ascendance of Laparoscopic Splenectomy. Walsh, R. Matthew; Heniford, B. Todd; Brody, Fredrick; Ponsky, Jeffrey // American Surgeon;Jan2001, Vol. 67 Issue 1, p48 

    The application of laparoscopic techniques for abdominal procedures has been achieved with varying success. The general acceptance of laparoscopic splenectomy (LS) may be hindered by its infrequent performance and difficulty in manipulating the spleen. A retrospective review of splenectomies...

  • Steep Learning Curve of Laparoscopic Splenectomy. Bagdasarian, Rainer W.; Bolton, John S.; Bowen, John C.; Fuhrman, George M.; Richardson, William S. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2000, Vol. 10 Issue 6, p319 

    Deals with a study which described the performance of laparoscopic splenectomy at the Ochsner Foundation Hospital in New Orleans, Louisiana in 1992. Indications for laparoscopic splenectomy; Complications of surgical procedures; Number of conversions to open splenectomy according to individual...

  • Splenectomy Using a Completely Needlescopic Procedure: Report of Three Cases. Tagaya, Nobumi; Rokkaku, Kyu; Kubota, Keiichi // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jun2002, Vol. 12 Issue 3, p213 

    Background and Purpose: Needlescopic instruments are being used in various fields of endoscopic surgery. We evaluated the safety and efficacy of laparoscopic splenectomy using a needlescope. Patients and Methods: This procedure was performed in three patients, two women and one man, having...

  • Laparoscopic Splenectomy for Ruptured Spleen: Lessons Learned from a Case. Basso, Nicola; Silecchia, Gianfranco; Raparelli, Luigi; Pizzuto, Gennaro; Picconi, Tullio // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr2003, Vol. 13 Issue 2, p109 

    Splenic rupture is a frequent consequence of blunt abdominal trauma. When nonsurgical management is not indicated, splenic rupture is usually an emergency requiring surgery. Removal of the spleen (splenectomy) or alternative conservative procedures (splenorraphy, partial splenectomy, and...

  • Laparoscopic Splenectomy at Caesarean Section. Hoey, Brian A.; Chapman III, William H.H. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Oct99, Vol. 9 Issue 5, p419 

    Presents a case of performing laparoscopic splenectomy at the time of Caesarean section. Reason for the popularity of laparoscopic splenectomy; Details of the case; Growth of the role of minimally invasive technique in the management of various surgical diseases.

  • Laparoscopic Splenectomy in Patients with Normal-Sized Spleens Versus Splenomegaly: Does Size Matter? Heniford, B. Todd; Park, Adrian; Walsh, R. Matthew; Kercher, Kent W.; Matthews, Brent D.; Frenette, Gary; Sing, Ronald F. // American Surgeon;Sep2001, Vol. 67 Issue 9, p854 

    Laparoscopic resection has become the standard means for removal of normal-sized spleens in many medical centers. The application of minimally invasive techniques in the setting of splenomegaly is less well defined and was previously considered a contraindication to the laparoscopic approach....

  • Laparoscopic Versus Open Splenectomy in the Pediatric Population: A Contemporary Single-Center Experience. Reddy, V. Seenu; Phan, Ho H.; O'Neill, James A.; Neblett III, Wallace W.; Pietsch, John B.; Morgan III, Walter M.; Cywes, Robert; Holcomb III, George W. // American Surgeon;Sep2001, Vol. 67 Issue 9, p859 

    The purpose of this study was to compare a recent contemporaneous experience between laparoscopic (LS) and open (OS) splenectomy in children. All splenectomy cases between 1994 and 1999 at our institution were reviewed. The study included open and laparoscopic cases performed according to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics