LAPAROSCOPIC SPLENOPEXY FOR WANDERING (PELVIC) SPLEEN

Wandering spleen is a rare clinical diagnosis with a high incidence of splenic torsion and infarction. The preferred treatment for this cond ition currently is splenopexy to reposition and fixate the spleen in t he left upper quadrant of the abdomen to preserve splenic function. We recently performed the first splenopexy for a wandering spleen using laparoscopic techniques. The patient was a 19-year-old woman who had a n asymptomatic lower abdominal/pelvic mass found on physical examinati on. Diagnostic evaluation (ultrasound, computed tomography scan, and L iver-spleen scan) showed an absent spleen in the upper abdomen, normal uterus and ovaries, and an 11 x 7-cm pelvic spleen. Laparoscopic sple nopexy was performed using Vicryl mesh to suspend and fixate the splee n in the left upper quadrant of the abdomen. Total operative time was 175 min, there were no intra- or postoperative complications, and the patient was discharged on the Ist postoperative day. Follow-up at 2 an d 7 months indicated that she was asymptomatic with a nonpalpable sple en. The results suggest that a laparoscopic approach to splenopexy sho uld be considered for the treatment of patients with a wandering splee n.