Лапароскопическая спленэктомия по поводу инфицированной кисты

A 50-year-old patient was admitted in an emergency 8 days ago for spontaneous hematomas, consciousness disorders and mucosal bleeding. Diagnosis of acute thrombocytopenia was established (1000 platelets/mm3). Medical treatment was started, including transfusion of platelets, gammaglobulins, corticosteroids) but the platelet count never went over 10,000 and after 2 days, it fell down again at 1000 platelets. It was decided to rapidly perform a splenectomy. The patient has a BMI of 30. The size of the spleen was estimated at 12cm. A laparoscopic approach was proposed.

We report the case of a 21-year-old woman with a cystic lesion of the spleen treated with a robotic partial splenectomy. The patient is placed in a right lateral decubitus position. Four ports are introduced into the left hypochondrium. The robot is placed at the level of the patient’s left shoulder. The intervention is begun with a lowering of the splenic flexure. Dissection is initiated at the upper pole of the spleen by retracting the stomach and by progressively dividing the different short vessels. It is decided to start the parenchymotomy approximately 1cm from the devascularized area. Transection is begun using an ultrasonic dissector. Hemostasis is subsequently achieved progressively. Transection is completed by means of a firing of the Endo GIA™ linear stapler. Hemostasis is further completed using the Aquamantys® system and bipolar sealers. The specimen is fully mobilized and placed in a bag. It is extracted by means of a small suprapubic Pfannenstiel’s incision. Pathological findings demonstrate the presence of an epidermoid cyst. The postoperative outcome is uneventful. The patient is discharged on postoperative day 4.

This the case of a 32-year-old lady who went to see her medical practitioner for a back pain and a calcification was discovered in the left upper quadrant of the abdomen. A CT-scan was performed and provided the diagnosis of a cyst of the spleen with a lot of calcifications. This cyst does not allow to perform a partial splenectomy, which is sometimes an indication if we have a cyst located at the upper or at the lower pole of the cyst. A laparoscopic live total splenectomy is presented.

This video shows the case of a young patient presenting with an 8cm splenic cyst associated with occasional left hypochondrium pain. A simple resection of the cyst dome is decided upon in order to heal the patient and preserve the spleen.

This is the case of a patient admitted to hospital for a sensation of lump in the left hypochondrium, which has been progressing for one week. The patient also reported a left hypochondrium pain. On clinical exam, a left hypochondrium sensitivity was observed and there was no sign of peritoneal irritation. An abdominopelvic CT-scan showed a voluminous splenic cyst of congenital origin (either an epidermoid cyst or a mesothelial cyst). Laparoscopic splenectomy is performed under general anesthesia. Pathological findings showed the presence of a multilocular epithelial cyst.