caa a22 4500 475779835 CHVBK 20180406123641.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s004640000210 doi (NATIONALLICENCE)springer-10.1007/s004640000210 Handport-assisted laparoscopic splenectomy in massive splenomegaly [Elektronische Daten] [P. Hellman, D. Arvidsson, J. Rastad] Background: Laparoscopic splenectomy of normal-sized spleens is performed with increasing frequency. By using a handport, which allows the intraperitoneal introduction of one surgeon's hand, massively enlarged spleens may also be extirpated via a laparopscopy-assisted technique. Methods: Seven patients (54-80 years) with massive splenomegaly (3.5-5.8 kg) underwent handport-assisted laparoscopic splenectomy. All patients had spleens that extended beyond the umbilicus, hypersplenism, and discomfort in the upper left quadrant due to intractable hematological malignancy. Results: Both the operation and recovery were uneventful in five of the patients, but one patient had to be converted to an open procedure due to splenic damage and bleeding, and another was reoperated for hemorrhage from a trocar. The handport allowed splenic protection while the trocars were introduced and instruments changed. It also enabled splenic mobilization, particularly prior to stapling of the hilar structures and dissection of the upper splenic pole. Conclusions: Handport-assisted laparoscopic splenectomy seems to be a viable alternative for massive splenomegaly, but it requires further evaluation with respect to safety, efficacy, and indication. Springer-Verlag New York Inc., 2000 Key words: Splenectomy — Laparoscopy — Handport — Splenomegaly — Hypersplenism nationallicence Hellman P. Department of Surgery, University Hospital, S-75185 Uppsala, Sweden, SE aut Arvidsson D. Department of Surgery, Karolinska Hospital, Stockholm, Sweden, SE aut Rastad J. Department of Surgery, University Hospital, S-75185 Uppsala, Sweden, SE aut Surgical Endoscopy Springer-Verlag 14/12(2000-12-01), 1177-1179 0930-2794 14:12<1177 2000 14 464 https://doi.org/10.1007/s004640000210 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000210 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hellman P. Department of Surgery, University Hospital, S-75185 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Arvidsson D. Department of Surgery, Karolinska Hospital, Stockholm, Sweden, SE aut NATIONALLICENCE 700 1- Rastad J. Department of Surgery, University Hospital, S-75185 Uppsala, Sweden, SE aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/12(2000-12-01), 1177-1179 0930-2794 14:12<1177 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer