Splenectomy is the surgical removal of the spleen, which is an organ that is part of the lymphaticLaparoscopic Splenectomy system. The spleen is a dark-purple, bean-shaped organ located in the upper left side of the abdomen, just behind the bottom of the rib cage. Splenectomies are performed for a variety of different reasons and with different degrees of urgency. Most splenectomies are done after the patient has been diagnosed with hypersplenism. Hypersplenism is not a specific disease but a group of symptoms, or syndrome that can be produced by a number of different disorders. It is characterized by enlargement of the spleen (splenomegaly), defects in the blood cells and an abnormally high turnover of blood cells. It is almost always associated with splenomegaly caused by specific disorders such as cirrhosis of the liver or certain cancers. The decision to perform a splenectomy depends on the severity and prognosis of the disease that is causing the hypersplenism.
There are some disorders in which splenectomy are usually recommended. They include:
Laparoscopic splenectomy is a surgical technique used to remove the spleen without making a large incision. You will be given general anesthesia. After you are asleep the anesthesiologist will probably insert a temporary tube into your stomach to empty it. This will help to decompress the stomach and prevent post-operative nausea. A catheter will be inserted into your bladder to drain the urine while you are asleep. Surgery may be done with you lying flat on your back or turned onto your right side depending on surgeon preference. Several small incisions are made into the abdomen. One is used for the laparoscope which is attached to a camera that sends images to a video monitor. The other incisions are used to hold or manipulate tissue in the abdomen. Carbon dioxide gas is insufflated into the abdominal cavity to allow room to work and to allow the surgeons to see. Parts of the spleen are freed from surrounding tissue. Blood vessels to the stomach and spleen are visualized, tied off or clipped with metal clips and divided. Once the spleen is dissected free of its attachments in the abdominal cavity, it is placed in a special surgical plastic bag and removed through one of the small abdominal incisions. If the spleen is too large to be removed in one piece, it will be broken up in the bag and removed as smaller pieces. At the end of the surgery, carbon dioxide gas is removed. The small incisions are closed with suture, the skin is cleaned and the incisions are covered with a small dressing.
Laparoscopic splenectomy is gaining increased acceptance as an alternative to open splenectomy for a wide variety of disorders, although splenomegaly still presents an obstacle to laparoscopic splenectomy; massive splenomegaly has been considered a contraindication. In patients with enlarged spleens, however, laparoscopic splenectomy is associated with less morbidity, decreased transfusion rates and shorter hospital stays than when the open approach is used. Patients with enlarged spleens usually have more severe hematologic diseases related to greater morbidity; therefore, laparoscopic splenectomy has potential advantages.
The most frequent serious complication following laparoscopic splenectomy is damage to the pancreas. Application of a hydrogel sealant to the pancreas during surgery, however, appears to significantly reduce the risk of leakage from the pancreas.
The other Gastro procedures are:
Few Major Hospitals for Laparoscopic Splenectomy are:
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