Removal of the spleen laparoscopically is done in lap splenectomy.
1. Immune thrombocytopenic purpura: In patients with failed medical therapy or requiring long term steroids.
3. Thalassemia major
5. Autoimmune haemolytic anaemia not responding to conservative treatment.
6. Diagnosis or treatment of leukaemias, lymphomas
7. Traumatic splenic injury which cannot be managed conservatively although open approach is preferred in these patients.
1. Laparoscopy helps to check presence of Accessory spleens present in 12-15% patients.
2. Better cosmesis
3. Lesser pain and immunological reaction in response to surgery
4. Faster return to routine life
5. Shorter hospital stay
1.Bleeding: May require conversion to open technique. If it happens postoperatively, may require repeat surgery.
2.Injury to pancreatic tail: May result in a pancreatic fistula.
3.Overwhelming postsplenectomy sepsis infection (OPSI): Is the most dreaded complication as it is associated with high mortality. Vaccinations against meningococcal, pneumococcal, and Haemophilus influenzae type B infections at least 2 weeks before the surgery is recommended in all elective cases. Post op vaccination can be given in emergency cases.
4. Portal vein thrombosis: It is seen in patients with splenomegaly, lymphatic malignancies and haemolytic disorders. If detected patients need anticoagulation.
5. Subphrenic collections and abscesses
6. Basal atelectasis