Pediatric laparoscopic splenectomy using the lateral approach

摘要: Laparoscopic splenectomy in children has been shown to be safe, reduce postoperative pain and hospital stay, accelerate return full activities. We describe our experience with a four-port "lateral" approach 18 patients. Patients were placed the lateral decubitus position table was flexed separate left subcostal margin iliac crest. The camera port inserted at umbilicus additional ports epigastrium lower quadrant. After mobilization of splenic flexure flank below 12th rib for elevation spleen. A 30 degrees laparoscope used vessels controlled an endo-GIA and/or clips. spleens bag, morcellated, extracted through site. Eight females 10 males median age 12.5 years (5-17 years) weight 55.5 kg (17-124 kg) underwent idiopathic thrombocytopenia purpora (10), spherocytosis (6), elliptocytosis (1), Hodgkin's disease (1). operating time 160 min (90-300 min) blood loss 105 ml (5-350 ml). Accessory removed four cases. Three patients required extensions site remove large which could not bag. sole complication transient pancreatitis associated pleural effusion. stay 2 days (1-11 days) activities 8 (3-25 days). affords excellent visualization vessels, pancreas, accessory spleens. This is safe reliable preferred laparoscopic children.