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CC BY 4.0 · European J Pediatr Surg Rep. 2020; 08(01): e81-e85
DOI: 10.1055/s-0040-1716894
Case Report

Laparoscopic Partial Splenectomy Assisted by Fluorescence in a 13-Year-Old Girl

Isabel Bada-Bosch
1   Department of Pediatric Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
,
David Peláez Mata
1   Department of Pediatric Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
,
Manuel de la Torre
1   Department of Pediatric Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
,
Javier Ordóñez 
1   Department of Pediatric Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
,
María Dolores Blanco
1   Department of Pediatric Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
,
Juan de Agustin
1   Department of Pediatric Surgery, Hospital General Universitario Gregorio Maranon, Madrid, Spain
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Abstract

Partial splenectomy allows preserving immune function in benign splenic lesions such as epidermoid cysts. Determining the plane of resection and perfusion of the spleen remnant can be difficult, especially in centrally located lesions. We present a 13-year-old girl with a symptomatic splenic cyst of 6 cm in diameter located next to the splenic hilum. Laparoscopic partial splenectomy was performed through a 10-mm umbilical approach and three accessory 5-mm ports. Intraoperative intravenous injection of indocyanine green (ICG) at 0.2 mg/kg guided the careful dissection of the splenic hilum and checked the spleen perfusion once the upper arterial branch was clamped. The subsequent wash-out of the ICG allowed inspection of the peripheral vascular return of the splenic remnant through polar veins. Surgery was uneventful with minimal blood loss. Follow-up ultrasound scan revealed a well-perfused small splenic remnant with no signs of recurrence.

Laparoscopic partial splenectomy is feasible in benign splenic tumors, especially in those cases of peripheral location. Fluorescence facilitates the safe dissection of the splenic hilum, the visualization of the transection plane of the spleen and the perfusion of the remnant in cases of anatomically and technically complicated partial splenectomies.

Keywords

partial splenectomy - laparoscopy - fluorescence - indocyanine green - pediatric


Publication History

Received: 14 May 2020

Accepted: 18 August 2020

Article published online:
21 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

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