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Abstract
The purpose of this study is to evaluate the visibility of
laparoscopic splenectomy in the treatment of some hematological
disorders. We operated on 30 patients with hematological diseases in
whom splenectomy were indicated, 15 patients (study group) underwent
laparoscopic splenectomy, the other 15 patients (control group)
underwent open splenectomy
The following patients were excluded from this study:
1. Patients with a history of bleeding tendency apart from those caused
directly by platelet disorders.
2. Patients with previous upper laparotomies.
3. Diagnosis of heart, kidney, liver diseases that contraindicates
laparoscopic or open surgical maneuvers.
4. Huge splenomegaly
5. Pregnancy.
Pre operative preparations of these patients were taken in the hematology
department and routine laboratory investigations were done in the form of
C.B.C., liver and kidney functions& bone marrow morphology.
Abdominal ultrasound imaging to assess splenic major long access
&other intra abdominal pathology was done to all cases preoperatively
We used the harmonic scalpel, which is dissecting and haemostatic vessel
sealing tool, to the laparoscopic procedures as it operates on the base of
ultrasound wave vibrations that are transmitted from it to the tissue
causing cutting and haemostasis simultaneously.
The use of harmonic scalpel &legasure in laparoscopic splenectomy were
safe and effective as they improved haemostasis(p<0.001), ease of
dissection, lessens the operative time, briefs hospitalization with rapid
return to work and hence better long term results.
Although the clinical implications of laparoscopic splenectomy in the
treatment of some hematological disorders are not frequently observed in
practice, this study suggests that laparoscopic splenectomy is ideal in the
treatment of some hematological disorders as compared to open surgery
as regard less operative time, brief hospitalization and hence better long
term outcome in expert well trained hands in well equipped centers.