Background
Laparoscopic splenectomy became the gold standard operation for many splenic disorders, successful completion of the operation depends to a large extent on splenic size and control of bleeding, which mostly occurs due to capsular tears during dissection or mal control of the splenic vessels. Splenic vessels could be controlled by ligasure, endoclips, or endo-GIA staplers.
Patients and methods
In all, 48 patients undergoing laparoscopic splenectomy were allocated into three groups according to the way we controlled the splenic vessels, each group had 16 patients. In group I, the ligasure was used for sealing splenic vessels; in group II endoclips were used for vessel control, and in group III endo-GIA stapler was used for control and transection of the splenic pedicle.
Results
All cases were completed by a laparoscope except one patient in group II who was converted due to uncontrolled bleeding; blood loss and postoperative drainage were significantly higher in the second group. Ligasure use made dissection easy and safe. Ligasure and endo-GIA staplers helped in reducing the operative time.
Conclusion
Ligasure and endo-GIA staplers are superior to endoclip application for the control of splenic vessels during laparoscopic splenectomy. Their combination helps in reducing the operative time.