الفهرس 
Anatomy of the spleenOnly 14 pages are availabe for public view
 |  | from | 145 |  |  |
| | | from | 145 | | |
Abstract
Lap splenectomy now is considered the gold standard in elective splenectomy of normal sized spleen or mild and moderate splenomegaly by the two classic approaches (anterolateral or posterior), while it can be done in much more sizable spleens
Other modifications of lap splenectomy have emerged including :
-Hand assisted technique which allows lap splenectomy of much larger sizes of spleens and decreases rate of conversion to open , particularly useful when dealing with tumors where gross picture is maintained & less chance of spillage , yet it has the disadvantage of less esthetic results. .
-Single port Splenectomy can be performed by umbilical or sub costal placement , the umbilical is more esthetic but technically difficult & nearly impossible in very tall or obese patients , subcostal placement is less esthetic but technically easier , still this operations needs high level of laparoscopic skills & the use of additional port or an incision for a drain.
-An alternative to SPS has emerged which is reduced port splenectomy that overcomes the technical difficulties in SPS and has operative time comparable to conventional lap splenectomy .
-Robot assisted splenectomy did not show any significant advantage over LS , and is still not cost effective.
-Transvaginal laparoscopic splenectomy has been reported , reducing port numbers and avoiding penetration of abdominal wall with 10-15 mm trochars .decreasing scars & hernia risk .
it also permits extraction of spleen without fragmentation
disadvantages of transvaginal lap splenectomy is mainly technical due to inadecuate length of the instruments to reach the superior pole of the spleen .
- Advances in medical instruments engineering make Recent techniques of lap splenectomy more promising & overcoming most of the technical difficulties , allowing less operative time , better esthetic results & lower rate of conversion to open .