Endoskopie 2012; 21(1): 4-7

Laparoscopic splenectomy

prof.MUDr.Zdeněk Kala, CSc.¹, MUDr.Vladimír Procházka, Ph.D.¹, MUDr.Libor Červínek²

¹ Chirurgická klinika FN Brno Bohunice a LF MU Brno

² Interní hematoonkologická klinika FN Brno Bohunice a LF MU Brno

Laparoscopic splenectomy is a safe procedure for various pathological conditions of the spleen and of haematopoiesis. Contraindications to

laparoscopic approach depend, in part, on the centre’s experience. Absolute contraindications are poor internal condition, portal hypertension,

and massive splenomegaly. The most frequent indication is idiopathic thrombocytopenic purpura. Treatment of thrombocytopenia

always begins with conservative first-line approaches: administration of corticosteroids and intravenous immunoglobulins. Splenectomy thus

remains second-line treatment in a small proportion of patients. Postoperative complications are uncommon. In addition to the cosmetic

effect, there is a considerably lower risk of large incisional hernia than in laparotomic approach in corticosteroid-dependent patients. Following

the procedure, it is always necessary to prevent thromboembolic disease by administering low-molecular-weight heparin.

Keywords: laparoscopy, splenectomy, thrombocytopenia, intravenous immunoglobulins, corticosteroid therapy

Published: December 1, 2012  Show citation