Laparoscopic splenectomy for splenomegaly using a homemade retrieval BAG

Abstract

Introduction

Operating on an enlarged spleen via the laparoscopic approach presents several challenges. A homemade bag may facilitate retrieval of the enlarged spleen assisted by a laparoscope and save medical expense.

Aim

To assess the feasibility and safety of laparoscopic splenectomy for moderate or massive splenomegaly using our technique and a homemade retrieval bag.

Material and methods

Fifty patients underwent laparoscopic splenectomy for moderate or massive splenomegaly which was defined as the major axis exceeding 17 cm by abdominal computed tomography. A homemade retrieval bag made from a commercial sterile infusion container which costs about US$ 1–2 per piece was used for spleen retrieval. Two transabdominal sutures for suspension of the retrieval bag were made to aid specimen removal in this technique.

Results

There were 31 males and 19 females with mean age of 56 ±11 years. Laparoscopic splenectomy was successfully completed in 49 of these 50 patients. Overall, mean operative time was 149 ±31 min (range: 100–252 min). Median estimated blood loss was 189 ±155 ml (range: 50–920 ml). There were 12 minor complications but no mortality. Time to discharge after surgery ranged from 3 to 9 (mean: 4.7 ±1.7 days). The average splenic weight was 729 ±74 g (range: 632–930 g).

Conclusions

Our preliminary results indicate that laparoscopic splenectomy is feasible and safe for moderate or massive splenomegaly and may be a well-tolerated alternative to open splenectomy. Not only is the cost of our homemade retrieval bag low, but also it is easy to make and ready to use.