Repair of splenic lesions with video-laparoscopy

Conservative therapy of spleen injuries (non-operative treatment, partial splenectomy, autotransplantation, etc.) makes it possible to avoid the risk related to post-splenectomy hyposplenism. The videolaparoscopic approach makes the performance of such treatment possible achieving a clear reduction in surgical stress. The authors report two multiple injured patients showing spleen lesions, treated conservatively through videocoelioscopic procedure. Both patients (a 42-year-old woman and a 26-year-old man) presented hemorrhagic shock in hemodynamic compensation and hemoperitoneum. Abdominal ultrasonographic scanning proved the presence of spleen injuries. Both patients underwent a conservative surgical videolaparoscopic treatment using fibrin glue and omentoplasty. The resolution of the hemorrhagic shock and the restoration of the spleen lesions were achieved in both cases. The authors have already used the videocoelioparoscopic approach both in elective (biliary lithiasis, inguinal hernia, appendicitis, etc.) and in emergency surgery (acute cholecistitis, perforated ulcer, intestinal obstruction, etc.). They note the effectiveness of the method, also in the field of the mini-invasive conservative treatment of parenchymatous organ lesions (mainly in the case of spleen injuries, when the splenic function has to be preserved). So, it's possible to add the advantages of a conservative treatment to those of the minimal invasivity, provided by the videolaparoscopic procedure.