What is laparoscopic splenectomy?

  Laparoscopic surgery is less traumatic, has a clear field of view, and offers patients a quick postoperative recovery and short hospital stay, with significant social benefits. Especially in tipped organs such as gallbladder and spleen, laparoscopic surgery has obvious advantages over open surgery.  Since the world’s first laparoscopic splenectomy (LS) was performed at the Royal Hospital in Lisbon, Australia in 1991, LS has now become one of the common laparoscopic substantive organ resections through the joint efforts of surgical specialists.  Associate Professor Liu Chen studied under Professor Ni Quanxing, a nationally renowned expert in surgery, and has been dedicated to immunological research, clinical diagnosis and treatment of pancreatic, hepatobiliary tumors for more than 10 years. In 2012, he was awarded the “Golden Finger” prize of the Chinese Medical Association Surgical Competition. At present, he is working on more than 10 projects, including 5 National Natural Science Foundation of China and 1 Sino-German Cooperation Project, and has published 8 SCI papers and more than 10 core journal papers as the first author or corresponding author.  Laparoscopic splenectomy can be divided into total laparoscopic splenectomy, hand-assisted laparoscopic splenectomy, and pneumoperitoneum-free laparoscopic splenectomy according to the difference of surgical approaches. Among them, total laparoscopic splenectomy is currently the most prevalent surgical approach. In addition, with the advanced understanding of spleen anatomy and physiology, laparoscopic partial splenectomy has also emerged in clinical practice.  The main indications for laparoscopic splenectomy are: (1) hematologic diseases requiring splenectomy: idiopathic thrombocytopenic purpura (ITP), hereditary spherocytosis, hemolytic anemia, etc.; (2) occupying splenic lesions, such as splenic cyst, splenic malformation tumor, splenic hemangioma, splenic lymphadenoma, etc.; (3) splenic trauma with stable vital signs; (4) cirrhosis with portal hypertension, hypersplenism, etc. The absolute contraindications to laparoscopic splenectomy are mainly cardiac, pulmonary and other important organ insufficiency, as well as difficult to correct coagulation mechanism disorders. Pregnancy, history of left upper abdominal surgery, splenic abscess, splenic malignancy and splenic artery aneurysm are relative contraindications to laparoscopic splenectomy.  The Institute of Pancreatic Oncology of Fudan University has successfully completed more than 80 cases of laparoscopic splenectomy since laparoscopic surgery was carried out in 2013. All patients recovered quickly and were discharged within a short period of time without surgical complications. Especially worth mentioning is that patient Lv, who recovered well more than 3 months after laparoscopic splenectomy in our hospital, participated in the Shanghai International Marathon on 2015.11.08 and ran the whole course with an excellent time of 3 hours, 57 minutes and 29 seconds, inspiring our patients and friends with practical actions!