Subtotal laparoscopic splenectomy for hemolytic disorders in a 5-year-old girl
Epublication WebSurg.com, Jun 2019;19(06). URL: http://websurg.com/doi/vd01en5657
In case of hemolytic disease, subtotal splenectomy is an alternative to total splenectomy, the efficacy of which has been evidenced in the literature (Inter J Surg 2010;8:48-51). This procedure is particularly relevant in young children as it precludes risks of infection related to total splenectomy. Subtotal splenectomy should reduce the size of the splenic parenchyma by 80% in order to prevent recurrence and completion surgery in the short term. In 2008, we had already reported a first multicentric study on subtotal splenectomy (Surg Endosc 2008;22:45-9). Technically, it is interesting to have access to an inconstant artery draining the superior pole of the spleen, which is then left in place (Surg Endosc 2006;21:1678). When this artery is not present, the superior pole of the spleen will be preserved as it is vascularized by one or two short vessels of the gastrosplenic omentum.