Chowbey, P.K.; Baijal, M.; Khullar, R.; Sharma, A.; Soni, V.; Vashishtha, A.; Dhir, A. and Dewan, A. (2002) Laparoscopic splenectomy. In: The 5th Annual Conference of Indian Association of Gastrointestinal Endo-surgeons (IAGES), 31st Jan - 3rd Feb 2002, Kolkatta, India.
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Current trends regarding indications for the need for splenectomy include trauma, in the management of patients with certain haemotologic disorders and in the staging of some patients with Hodgkin's disease. The ideal patient for laparoscopic splenectomy is the one suffering from ITP because the splenic enlargement is only moderate. The problem of organ extraction can be managed by placing the spleen in an endobag and taking it out piecemeal or by using a morcellator. For spleens which are large or are unusually difficult to handle, the technique of hand port surgery (HPS) is particularly suited. The rationale for Hand assisted laparoscopy (HAL) is that the incision made for retrieving the specimen at the end of a lengthy procedure can favourably be made in the beginning- for insertion of the surgeons hand. This not only increases the surgeons efficiency but also preserves the advantages of minimal access surgery to the patient. Here we present both the ways of laparoscopic splenectomy i.e. total laparoscopic & hand assisted showing the feasibility and safety of surgery for small as well as large spleens.
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