الفهرس | Only 14 pages are availabe for public view |
Abstract SUMMARY The spleen is the largest organ of the lympho-reticular system. Its primary functions include hematopoiesis and immune protection. It acts as a filter for abnormally shaped blood cells and some metabolic products. Also, it has the ability to store blood and contract in response to acute changes in blood volume in trauma and it becomes the focus of surgical attention in a variety of circumstances. The spleen contains phagocytes that remove exhausted erythrocytes and foreign bodies from the blood and it is a major reservoir for blood. Absence of the spleen predisposes to certain infections. In a report in early 1990s, the dissection of the hilum of the spleen was generally achieved by surgical clips or endo-gastrointestinal staplers. Subsequently, new surgical tools such as ultrasonic devices or bipolar electrosurgical devices such as LigaSure had been employed as supporting device that can seal blood vessels with supraphysiologic burst pressures equal to those obtained with surgical clips or ligatures. The study is to evaluate feasibility, merits and demerits of stapleless laparoscopic splenectomy in cases of non traumatic disorders of spleen. And assess operative time, need for blood transfusion, rate of conversion to open splenectomy or use stapler, period of hospital stay and associated complications. The study was conducted at the surgical department at Beni-suef University hospital. Within the period between August 2018 to August 2019. Most cases were referred by hematology department as candidates for splenectomy due to hematological diseases. The study was conducted on 16 patients, underwent laparoscopic splenectomy using vessel sealing device (Ligasure) for splenic pedicle control. informed consent was obtained for all patients. Several reports support suture-less and staple-less LS using LigaSure as a safe and time-sparing procedure of treatment for spleen hematologic and non-traumatic diseases. We, in this series, believe that it is, with a statistical significance, safe and effective, reduces blood loss, minimize operating time, and is a valid. Moreover, it reduced conversion rates in selected patients. Last but not least, the use of the Ligasure Vessel Sealing System resulted in no post-operative complications or need of blood transfusion. |