Laparoscopic splenectomy in children : experience at the royal medical services

الملخص EN

Objective : the role of laparoscopic surgery in children continues to expand at rapid rate.

Laparoscopic splenectomy is an example of the recent continued advancement.

The purpose of the present study is to evaluate the feasibility, safety, and outcomes of patients undergoing laparoscopic splenectomy.

Methods : this is a retrospective study conducted during the period from January 1998 to December 2004.

All children who underwent elective laparoscopic splenectomy were included in the study.

Data on patient's demographics, indications for surgery, operative time, intraoperative events, surgical morbidity, time until regular diet was began, hospital stay, and time until return to daily activity were collected and analyzed to evaluate the feasibility and safety of laparoscopic splenectomy.

Results : A total of 21 patients underwent laparoscopic splenectomy.

Indications for surgery were idiopathic thrombocytopenia, hereditary Spherocytosis, and splenic Hydatid cyst.

Mean size of spleen was 12cm.

Mean surgical time was 100 minutes and greater in the first 10 cases than the last 11.

Accessory spleen was found in one patient with ITP.

In two instances (9 %) conversion to open splenectomy was necessary due to failure to progress in dissection, and a technical reason.

Mean post-surgical stay was two days.

One patient developed lung atelectasis that was successfully treated.

No long term complications were observed.

Conclusions : our study clearly indicates that laparoscopic splenectomy is a safe and successful procedure in children.

It offers the well-known advantages of minimal invasive surgery.