MINILAPAROSCOPIC SPLENECTOMY - A NEW MINIMALLY INVASIVE APPROACH

This report introduces our new technique in laparoscopic splenectomy. A 2-mm mini-laparoscope and a conventional 10-mm laparoscope were used alternatively during the procedure, with a result of nearly no visibl e scar after the operation. Two young females diagnosed with idiopathi c thrombocytopenic purpura, refractory to medical treatment, underwent laparoscopic splenectomy in our hospital. The whole procedure was fin ished through one 12-mm port (supraumbilical) and three 2-mm ports (su bxiphoid, left midclavicular, and left midaxillary). The short gastric vessels and splenic vessels were clipped and divided by Endo-GIA II: (U.S. Surgical Corp., Norwalk, CT) that was applied through the 12-mm port. The spleen was placed in a bag and was fractured to be removed p iece by piece. A drain tube was not necessary after meticulous hemosta sis. Two weeks after the operation, only three tiny wounds, resembling mosquito bites, were present at the left subcostal region. In conclus ion, minilaparoscopic splenectomy is feasible and safe for patients wi th idiopathic thrombocytopenic purpura, and may ultimately be an alter native choice for patients desiring superior cosmesis.