THE ANATOMICAL BASIS FOR LAPAROSCOPIC SPLENECTOMY

The anatomy of the splenic blood supply is extremely variable. Two pri ncipal patterns, the distributed and the magistral types, include the majority of variations. These two types differ with respect to the len gth of the splenic trunk, the number of arterial branches and the prop ortion of the medial surface of the spleen occupied by the branches as they enter the organ. The suspensory ligaments of the spleen, includi ng the sustentaculum lienis, are usually avascular except for the gast rocolic and lienorenal ligaments on the medial side. The tail of the p ancreas touches the spleen in 30% of cases and lies within 1 cm of the spleen in 73%. Knowledge of these basic anatomic facts and the variat ions should contribute to the safety of laparoscopic splenectomy.