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2016 ; 20
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Vacuum Stabilization of the Spleen in Laparoscopic Splenectomy
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Gan PS
JSLS
2016[Jan]; 20
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BACKGROUND AND OBJECTIVES: Recovery from laparoscopic splenectomy is greatly
enhanced when compared with recovery from the laparotomy approach, yet a minority
of spleens are removed laparoscopically. The spleen is smooth, rounded, and
vascular, making it difficult to directly grasp, stabilize, or retract
laparoscopically. The LiVac Retractor is a laparoscopic liver retractor
comprising a soft silicone open ring that apposes 2 substantially planar surfaces
when a vacuum is applied. It was evaluated for its efficacy in stabilization of
the spleen during 2 laparoscopic splenectomies. METHODS: The 2 patients gave
consent for laparoscopic splenectomy with splenic retraction using the LiVac
Retractor. The entire 3-port laparoscopic procedure was video recorded, with the
resected spleens weighed as wet specimens. The patients' postoperative courses
are described. RESULTS: The spleen was retracted securely for the duration of the
hilar dissection in both patients. Exposure of the splenic hilum was excellent.
There were no visible signs of injury to either spleen and recovery of both
patients was unremarkable. CONCLUSIONS: The LiVac Retractor provided stable
retraction and excellent exposure of the splenic hilum during both laparoscopic
splenectomies, without organ injury. Early hilar dissection with vascular control
was facilitated, reducing the risk of bleeding from other components of the
dissection.