Where is the incision for a splenectomy?

The spleen is removed while you are under general anesthesia (asleep and pain-free). The surgeon may do either an open splenectomy or a laparoscopic splenectomy. During open spleen removal: The surgeon makes a cut (incision) in the middle of the belly or on the left side of the belly just below the ribs.

How is a patient positioned for splenectomy?

Presently, few surgeons prefer the supine position for adult laparoscopic splenectomy uncomplicated by massive splenomegaly or the need to perform concomitant procedures. The patient is placed supine on the operating table with lower extremities together and the upper extremities at the patient’s sides (Figure 16.1.

Can splenectomy be done laparoscopically?

Splenectomy is most commonly performed using a tiny video camera and special surgical tools (laparoscopic splenectomy). With this type of surgery, you may be able to leave the hospital the same day and recover fully in two weeks.

What is lateral splenectomy?

The lateral approach to laparoscopic splenectomy has the advantage of better visualization of the splenic hilum and the tail of the pancreas, thus avoiding injury and enhancing dissection of the ligaments. In case of necessity of conversion to open surgery, a subcostal incision may be used.

What is a laparoscopic splenectomy?

Laparoscopic splenectomy (LS) is the gold standard procedure to remove the spleen in elective patient (1), but remains a very delicate procedure due to fragility of parenchyma and capsule of the spleen and its close connections with stomach, pancreas and colon.

What position is Trendelenburg?

The Trendelenburg position is a position for a patient on the operating table, most commonly used during lower abdominal surgeries and central venous catheter placement. In Trendelenburg position, the patient is supine on the table with their head declined below their feet at an angle of roughly 16°.

What is the spleen connected to?

Anything that relates to the spleen is referred to as splenic; the spleen receives blood through the splenic artery, and blood leaves the spleen through the splenic vein. Although the spleen is connected to the blood vessels of the stomach and pancreas, it is not involved in digestion.

What are the side effects of not having a spleen?

If the spleen does not work properly, it may start to remove healthy blood cells. This can lead to: anaemia, from a reduced number of red blood cells. an increased risk of infection, from a reduced number of white blood cells.

Is spleen removal a big operation?

Removing your spleen is a major surgery and leaves you with a compromised immune system. For these reasons, it’s only performed when truly necessary. The benefits of a splenectomy are that it can resolve several health issues such as blood diseases, cancer, and infection that could not be treated any other way.

Where are the trocars placed in a laparoscopic splenectomy?

Lateral Approach to Laparoscopic Splenectomy. Subsequent trocars are placed after diagnostic laparoscopy; placement varies, depending on the patient’s body habitus and spleen size. All ports should be placed 3-4 cm below the inferior tip of the spleen to allow adequate working space for visualization and safe instrument exchange.

Which is the best lateral approach to laparoscopic splenectomy?

Lateral Approach to Laparoscopic Splenectomy. One potential strategy is to start with all 5-mm trocars and a 30° 5-mm laparoscope when visualization is satisfactory. After initial dissection and splenic mobilization, the port that gives the best angle for hilar ligation can be “upsized” to 12 mm for use of the endoscopic stapler.

How is computed tomography used in splenectomy?

Preoperative imaging with computed tomography (CT) or ultrasonography (US) can facilitate operative planning by assessing splenic size, locating accessory spleens, and aiding in decisions regarding port placement and surgical technique (laparoscopic, hand-assisted, or open).

Are there any single port laparoscopic lateral approaches?

Single-port techniques will not be described further here. For the lateral approach, the operation begins with safe laparoscopic abdominal access. This can be accomplished with an open or a closed technique, in accordance with the skill, experience, and comfort level of the surgeon.