LAPAROSCOPIC SPLENECTOMY

Dramatic decreases in length of hospital stay and time to complete rec overy with laparoscopic cholecystectomy have led to the development of more advanced laparoscopic procedures. The rationale, technique, and early results with laparoscopic splenectomy are described in this arti cle. Laparoscopic splenectomy is a complex procedure with a real poten tial for significant operative bleeding, but it can be accomplished su ccessfully in greater than 80% of selected patients with minimal blood loss. If successful, length of stay is reduced in most patients to 1 to 3 days, but this benefit is not always seen in patients with compli cated medical problems or with massive splenomegaly. The effects of in creased blood loss in patients whose operations are converted to open operations are also not yet clear. Laparoscopic splenectomy is a proce dure with great potential, but it is still in evolution.