Pediatric laparoscopic splenectomy: our experience and technique

Pediatric laparoscopic splenectomy is a relatively new surgical procedure, Advances in instrumentation and technique now make this procedure possible. Splenectomy is frequently performed in children for various hematologic an d autoimmune diseases. Patients and methods, - This article reviews the indication for splenectomy , the technique of laparoscopic splenectomy and our results. Between Januar y 1996 and January 2000, 23 children underwent laparoscopic splenectomy. Th ree of them also had a concomitant cholecystectomy. Their ages ranged from three to 14 years. Nine children had hereditary spherocytosis, four were af fected by sickle cell disease, three had an idiopathic thrombocytopenia and three a hemolytic disease. One patient was converted. Results. - Mean operative time was 170 min (range, 115-230 min). Hospital s tay ranged from three to 15 days (median, 6). Five patients had complicatio ns (three pneumonia and two deep abcesses). Median follow-up was 20 months (two months to four years) without problems regarding procedure. Conclusion . - Regarding the low complication rate for this type of patient and the ad vantages of a small abdominal trauma in the postoperative period, the lapar oscopic approach for elective splenectomy in hematological disorders is the technique of choice. (C) 2001 Editions scientifiques et medicales Elsevier SAS.