LAPAROSCOPIC SPLENECTOMY IN CHILDHOOD HEMATOLOGIC DISORDERS

Laparoscopic splenectomy is a new technique that is being utilized in patients with a variety of mostly hematologic disorders. Its applicati on in children has not been extensively documented. Between January 19 94 and February 1995, 11 children less than 15 years of age underwent elective laparoscopic splenectomy. Data collected from this treatment group were compared to that from the ten most recent open splenectomy patients with comparable hematologic disorders. All procedures in both groups were successful in relief of symptoms, increase in platelet co unt, and/or increase in hematocrit. Operative times averaged 147 min i n the laparoscopic group, compared to 112 min in the open group. Estim ated blood loss was 32 mi in the laparoscopic group and 86 mi in the o pen group. Days to laparoscopic patient discharge were 3.6, compared t o 5.3 days in the open group. There were no wound complications or nee d for perioperative platelet transfusions in the laparoscopic patients . Patient response has been uniformly positive in the laparoscopic gro up. Reusable access trocars are utilized for two of the four working p orts. Stapling devices and special tissue morselizers are not required . There are no additional operating room or surgeon's fees incurred in the laparoscopic procedures. This series demonstrates that laparoscop ic splenectomy is a safe, cost-efficient alternative to open splenecto my in children with a variety of hematologic disorders.