Laparoscopic splenectomy for massive splenomegaly using a Lahey bag

• 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
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(01)00632-8

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.