Can all patients have a laparoscopic splenectomy?
No. Patients with a very large spleen are generally best treated with an open splenectomy. The operation is considerably more difficult, more likely to not be possible and more likely to develop complications. Patients with a normal-sized spleen are all candidates for the laparoscopic approach unless they have other medical problems that put them at risk, such as severe heart or lung disease. Overall, 95% of patients with a normal- sized spleen will be able to have a splenectomy completed laparoscopically. What factors make a patient a less than optimal candidate for a laparoscopic approach? There are a variety of factors which decrease the chance of the surgeon being able to complete the procedure laparoscopically. These include: • Larger spleen than anticipated • Inflammation • Previous surgery • Unclear anatomy • Pregnancy • Previously unrecognized abnormalities • An intraoperative problem, such as bleeding Conversion of a laparoscopic procedure to an open one should not to be viewe
