TECHNIQUES OF LAPAROSCOPIC MORCELLATION OF THE SPLEEN

Laparoscopy has recently been applied to solid organ removal. We attem pted laparoscopic splenectomy in 20 selected patients with various hae matologic disorders. It was performed successfully in 18 (90%) patient s. The mortality was nit and the post-operative morbidity was low (17% ). Splenic extraction was performed by specimen fragmentation in a pla stic bag or by minilaparotomy in cases of splenomegaly or tumours of u ncertain origin, One of the disadvantages of laparoscopic surgery is t he removal of subsequent large solid organs. To facilitate splenic ext raction, we use digital fragmentation in an impervious nylon bag and a morcellator device is not mandatory. We have widened the indications for splenic morcellation to lymphomas and Hodgkin's disease because re liable histological examination is still possible.