Splenic artery aneurysms: Methods of laparoscopic repair

Purpose: Surgical therapy for splenic artery aneurysms (SAAs) has tradition ally consisted of a laparotomy with resection of the aneurysm and possibly a splenectomy. Our early experience with the laparoscopic approach to treat SAAs is reported. Methods: A retrospective review of medical records was conducted on all pat ients who underwent laparoscopic resection of SAAs at the Cleveland Clinic Foundation from May 1996 to August 1997. Results: Pour patients with SAAs, three women and one man, with an average age of 55 years (range, 37 to 63 years), underwent successful laparoscopic SAA repair. The average size of the aneurysm was 3.2 cm (range, 2.5 to 5.0 cm). Three patients underwent an aneurysm resection, whereas one patient un derwent simple ligation. Intraoperative ultrasound scanning with Doppler wa s used in three cases as a means of localizing the aneurysm and identifying all feeding vessels; the complete cessation of flow within the aneurysm in the case in which the feeding vessels were simply ligated was also documen ted. The average intraoperative time was 150 minutes (range, 100 to 190 min utes). The mean estimated blood loss was 105 mL (range, 20 to 300 mL). Ther e were no intraoperative complications. The average hospital stay was 2.2 d ays (range, 1 to 4 days). Conclusion: The laparoscopic approach to splenic artery aneurysm by aneurys mectomy or splenic artery ligation can be safe and effective. The laparosco pic approach affords a short hospital stay and an effective result.