Laparoscopic Splenectomy According to Spleen Size: a 19 Years’ Experience Study of a Single Institution

The laparoscopic approach is commonly used when splenectomy is required. The aim of this study is to present our department’s 20 years of experience in laparoscopic splenectomy, with emphasis to the technique employed according to spleen size. We have analyzed our department’s data concerning laparoscopic splenectomy (LS) from January of 2000 until January of 2019. During this time, 119 laparoscopic splenectomies were performed. Ninety-three procedures were categorized as total laparoscopic splenectomies (TLS) and 26 as hand-assisted laparoscopic splenectomies (HALS). In addition, during the same period, 115 patients underwent open splenectomy (OS). Conversion to open splenectomy was necessary in 11 (9.24%) cases. There were 5 (4.2%) cases of postoperative bleeding. A complication rate of 8.4% after LS is to be reported. In our series there was 1 death (0.84%). We performed LS in 78 patients with immune thrombocytopenia (ITP) with a remission rate of 84%. LS is a widely used procedure, even in patients with ITP who present with low platelet count. An experienced surgeon can perform LS even in large spleens.