Laparoscopic splenectomy for massive splenomegaly using a Lahey bag

Background: Although the recent development of hand-assisted laparoscopic surgery (HALS) has made the laparoscopic retraction of large spleens feasible, the laparoscopic removal of massively enlarged spleens (>1,000 g) remains a significant problem because these spleens do not fit into endoscopic...

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Bibliographic Details
Published in:The American journal of surgery 2001-06, Vol.181 (6), p.543-546
Main Authors: Greene, Arin K, Hodin, Richard A
Format: Article
Language:English
Subjects:
Abdomen
Adult
Aged
Biological and medical sciences
Complications
Contraindications
Endoscopy
Humans
Lahey bag
Laparoscopy
Laparoscopy - methods
Liver, biliary tract, pancreas, portal circulation, spleen
Male
Medical sciences
Morbidity
Patients
Spleen
Splenectomy
Splenectomy - methods
Splenomegaly
Splenomegaly - surgery
Splenosis
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Technology. Biomaterials. Equipments
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Summary:Background: Although the recent development of hand-assisted laparoscopic surgery (HALS) has made the laparoscopic retraction of large spleens feasible, the laparoscopic removal of massively enlarged spleens (>1,000 g) remains a significant problem because these spleens do not fit into endoscopic bags. Consequently, in order to remove massive spleens either a large abdominal incision or morcellation of the spleen outside of an endoscopy bag is required. Methods: Two patients, with spleens weighing 2,510 g and 1,720 g, underwent laparoscopic splenectomy using a hand port to ensure safe retraction. The massive spleen was placed into a Lahey bag that was inserted into the abdomen through the hand port site. While in the Lahey bag, the spleen was removed piecemeal through the hand port site. Results: Both operations were completed laparoscopically without complications. The patients were discharged on postoperative day 2 and experienced minimal morbidity. Conclusions: The Lahey bag facilitates laparoscopic splenectomy for massive splenomegaly as even the most massive spleens will fit into a Lahey bag. A massive spleen may be removed piecemeal from the Lahey bag through the small hand port incision without risking a large abdominal incision, splenosis, or the insertion of a morcellator.
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(01)00632-8