Laparoscopic Partial Splenectomy

Raghavendra Rao, MD; Sophia Abdulhai, MD; Todd A. Ponsky, MD, FACS; Mark McCollum, MD

Product Details
Product ID: ACS-5640
Year Produced: 2018
Length: 7 min.


Patient was a 15 yr female with a diagnosis of a 16cm splenic cyst with mass effect on the abdominal organs and the splenic parenchyma. A partial splenectomy was planned. After placing in right lateral decubitus position, abdomen was insufflated with Verres needle and an infra-umbilical 5 mm trocar was placed for the camera. Three 5mm ports were placed-2 in LLQ and 1 in epigastrium. Splenocolic attachments and short gastric vessels were taken down. The cyst was aspirated with a laparoscopic needle. The cyst was necrotic medially and was adherent to the diaphragm and the left lateral chest wall. Attachments to the chest wall and diaphragm was then taken down with blunt dissection and harmonic energy. The cyst was then entered and resected at its junction with normal spleen using the Caiman device. This device is an advanced bipolar device with long jaws and uniform gripping owing to its 'tip-first closure' and aids in uniform cauterization with minimal thermal spread. There was excellent hemostasis and the final EBL was 100cc. After complete resection of the cyst, the umbilical port was exchanged for a 12mm port and the entire specimen was extracted from this site. Greater omentum was placed and tacked to the residual cyst cavity. Fluid in the abdomen was aspirated and umbilical port was closed with Endoclose device. Patient did well post-op and was on regular diet on POD1. She was followed-up in 3 weeks with no issues and had an USG in 3 months which showed no recurrence.