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Case Reports
. 2010 Apr-Jun;14(2):286-8.
doi: 10.4293/108680810X12785289144809.

Single incision laparoscopic splenectomy in a 5-year-old with hereditary spherocytosis

Erik N Hansen  1 , Oliver J Muensterer
Affiliations
Case Reports

Single incision laparoscopic splenectomy in a 5-year-old with hereditary spherocytosis

Erik N Hansen et al. JSLS. 2010 Apr-Jun.

Abstract

Background: Single incision laparoscopic surgery (SILS) is an emerging technique that has been used as an approach for appendectomy, cholecystectomy, and splenectomy. We describe the technique of single incision laparoscopic splenectomy for hypersplenism in a 5-year-old boy with spherocytosis.

Case report: The patient required blood transfusions for anemia secondary to hypersplenism. His spleen measured 9.8 cm in cranio-caudal length on ultrasound. SILS splenectomy was performed through a 2-cm umbilical incision by using 3 ports. The splenic attachments were taken down using an electrosurgical sealing and cutting device, and the hilum was transected with an endosurgical stapler. The spleen was placed in an endosurgical bag, morcellated, and removed from the abdomen via the umbilical incision without complications. Operative time was 84 minutes; blood loss was minimal.

Conclusion: SILS splenectomy is feasible in pediatric patients. More experience is needed to assess advantages and disadvantages compared with the standard laparoscopic approach.

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Figures

Figure 1.
Figure 1.
Trocar positioning in the umbilical incision.
Figure 2.
Figure 2.
Division of the splenophrenic ligament. Note parallel alignment of instruments.
Figure 3.
Figure 3.
Umbilical incision after closure.
See this image and copyright information in PMC

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