How to do a Splenectomy | Laparoscopic Surgery | Modern Techniques

In this article we learn about the Splenectomy and its procedures in brief. So, please contact with me until the end of the paragraph..

                        Splenectomy is a surgical procedure to remove your spleen. The spleen is an organ that sits under your rib cage on the upper left side of your abdomen. It helps to fight infection and filters unneeded material, such as old damaged blood cells, from your blood.

Spleen

The spleen is reddish and is the largest single mass of lymphoid tissue in the body. It is oval shaped and has a notched anterior border. It lies just beneath the left half of the diaphragm close to the ninth, tenth and eleventh ribs. The long axis lies along the shaft of the tenth rib and its lower pole extends forward only as far as the midaxillary line and cannot be palpated on clinical examination.

Topography of the spleen 

English- spleen 

Latin- Splen

Morphology:

- 2 ends are distinguished: anterior and posterior ends.
- 3 borders are distinguished: superior, inferior and intermediate borders.
- 2 surfaces are distinguished: diaphragmatic (facies diaphragmatica) and visceral surfaces (facies visceralis).

Functions:

- Participating in reticuloendothelial system.

- Participating in lymphopoiesis.

- Participating in haemopoiesis during fetal life.

- Reservoir and destruction of erythrocytes.

Ligaments:

- The spleen is surrounded by peritoneum, which passes from it at the hilum as the gastro- splenic omentum (ligament) to the greater curvature of the stomach (carrying the short gas- tric and left gastroepiploic vessels).

- The peritoneum also passes to the left kidney as the splenicorenal ligament (carrying the splenic vessels and the tail of the pancreas).

Splenectomy

Indication:

- Traumatic injury (wound, rupture)

- Echinococcosis

- Haemolytic Jaundice 

- Werlhoff’s disease 

- Splenomegaly accompanied with portal hypertension 

- Congenital anomaly of the spleen 

Procedure:

We learned the topography of spleen and the indications of the splenectomy. Now we are learn continue about the whole operation of spleen. I will mentioned a video for you to understand the process very well.

-  The patient lies on the back or on the right side with a roller placed under the     waist.

-  Endotracheal necrosis is administered.

-  Either upper oblique laparotomy parallel to the left costal arch or superior midline laparotomy is performed.

- The costal arch is drawn out superiorly; the transverse colon and stomach are drawn out to the right and inferiorly.

- The phrenicolienal ligament is found and dissected. In case of bleeding in the

abdominal cavity due to rupture of the spleen, haemostatic forceps is applied.

- Then the gastrolienal ligament is dissected in parts, stitched and ligated.

- To prevent bleeding, the splenic artery is ligated. But owing to the fact that the short

gastric arteries are also branches of this artery, it is forbidden to ligate its trunk.

Only the branches to the spleen (which are located near to the hilus) are ligated.

-After the ligation of the splenic artery, the splenic vein is also ligated.

-The spleen is then removed. A puncture is made on the left hypochondrium for

drainage.