Laparoscopic Splenectomy

  • Jeffrey C. Pence
  • Keith T. Oldham


The elucidation of splenic function in health and disease has been continuously evolving since Aristotle dismissed the concept that it is essential for human existence more than 2000 years ago. The first recorded splenectomy was performed by Zaccarelli in 1549 for presumed malaria in a young woman who survived at least 6 years postoperatively [1]. The nonessential nature of the spleen was reinforced in subsequent animal experimentation following Read’s successful splenectomy in a dog in 1638 [2]. Quittenbaum [3], in 1826, is credited with the initial well-documented splenectomy in a young woman with probable portal hypertension and splenomegaly. The patient expired postoperatively from exsanguination. Despite this dismal early outcome, splenectomy became an acceptable practice for idiopathic hypertrophy, malarial hypertrophy, splenic anemia, leukemia, cysts, and tuberculosis, with an associated mortality rate of 13% by 1908 [4].


Laparoscopic Splenectomy White Pulp Accessory Spleen Hilum Figure Splenic Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Coon WW: The spleen and splenectomy. Surg Gynecol Obstet 1991, 173:407–414.PubMedGoogle Scholar
  2. 2.
    Read A: The early history of surgery in Great Britain. Quoted by Parker G. London: Robert Hale, Ltd; 1960:42–43.Google Scholar
  3. 3.
    Quittenbaum KS: Commentarii de splenic hypertrophiae et historia extirpationis. Quoted by Simon G. Paris: Rostok; 1836.Google Scholar
  4. 4.
    Johnston GB: Splenectomy, with a statistical summary of all reported cases up to 1908. Ann Surg 1908, 48:56–65.CrossRefGoogle Scholar
  5. 5.
    Bland-Sutton J: Observation on the surgery of the spleen. Br J Surg 1913, 1:157–172.CrossRefGoogle Scholar
  6. 6.
    Sherman R: Perspectives in the management of trauma to the spleen: 1979 Presidential Address, American Association for the Surgery of Trauma. J Trauma 1980, 20:1–13.PubMedGoogle Scholar
  7. 7.
    King H, Shumacker HB Jr: Splenic studies: I. Susceptibility to infection after splenectomy performed in infancy. Ann Surg 1952, 136:239–242.PubMedCrossRefGoogle Scholar
  8. 8.
    Halpert G, Gyorkey F: Lesions observed in accessory spleens of 311 patients. Am J Clin Pathol 1959, 32:165–168.PubMedGoogle Scholar
  9. 9.
    Erakis AJ, Filler RM: Splenectomy in childhood: a review of 1413 cases. J Pediatr Surg 1972, 7:382–388.CrossRefGoogle Scholar
  10. 10.
    Seufert R, Mitrou P: The diseased spleen. In Surgery of the Spleen. Edited by Reber HA. New York: Thieme Inc; 1986:27–32.Google Scholar
  11. 11.
    Michels NA: The variational anatomy of the spleen and splenic artery. Am J Anat 1942, 70:21–72.CrossRefGoogle Scholar
  12. 12.
    Russell SJ, Richards JDM: Medical indications for splenectomy. Br J Hosp Med 1989, 42:120–128.PubMedGoogle Scholar
  13. 13.
    Aster RH: Pooling of platelets in the spleen. J Clin Invest 1966, 45:645–657.PubMedCrossRefGoogle Scholar
  14. 14.
    Hill-Zobel RL, McCandless B, Kang A, et al.: Organ distribution and fate of human platelets: studies of asplenic and splenomegalic patients. Am J Hematol 1986, 3:231–238.CrossRefGoogle Scholar
  15. 15.
    Constantopoulos A, Najjar VA, Wish JB: Defective phagocytosis due to tuftsin deficiency in splenectomized subjects. Am J Dis Child 1973, 125:663–665.PubMedGoogle Scholar
  16. 16.
    Frank EL, Neu HC: Postsplenectomy infection. Surg Clin North Am 1981, 61:135–155.Google Scholar
  17. 17.
    Morris DH, Bullock FD: The importance of the spleen in resistance to infection. Ann Surg 1919, 70:513–521.PubMedCrossRefGoogle Scholar
  18. 18.
    Walker W: Splenectomy in childhood: a review in England and Wales 1960–1964. Br J Surg 1976, 63:36–43.PubMedCrossRefGoogle Scholar
  19. 19.
    Singer DB: Postsplenectomy sepsis. Perspect Paediatr Pathol 1973, 1:285–311.Google Scholar
  20. 20.
    Diamond LK: Splenectomy in childhood and the hazard of overwhelming infection. Pediatrics 1969, 43:886–889.PubMedGoogle Scholar
  21. 21.
    Van Wyck DB: Overwhelming postsplenectomy infection (OPSI): the clinical syndrome. Lymphology 1983, 16:107–114.PubMedGoogle Scholar
  22. 22.
    Ellison EC, Fabri PJ: Complications of splenectomy, etiology, prevention, and management. Surg Clin North Am 1983, 63:1313–1330.PubMedGoogle Scholar
  23. 23.
    Shaw JHF, Print CG: Postsplenectomy sepsis. Br J Surg 1989, 76:1074–1081.PubMedCrossRefGoogle Scholar
  24. 24.
    Dameshek W: Hypersplenism. Bull NY Acad Med 1955, 31:113–136.Google Scholar
  25. 25.
    Fischer J, Wolf R, Gramm H: Die Milzszintigraphie. Dtsch Arztebl 1973, 70:401–403.Google Scholar
  26. 26.
    Traetow WD, Fabri PJ, Carey LC: Changing indications for splenectomy. Arch Surg 1980, 115:447–451.PubMedCrossRefGoogle Scholar
  27. 27.
    Fabian TC, Croce MA, Stewart RM, et al.: A prospective analysis of diagnostic laparoscopy in trauma. Ann Surg 1993, 217:557–564.PubMedCrossRefGoogle Scholar
  28. 28.
    Akwari OE, Itani KMF, Coleman RE, Rosse WF: Splenectomy for primary and recurrent immune thrombocytopenia purpura (ITP). Ann Surg 1987, 206:529–539.PubMedCrossRefGoogle Scholar
  29. 29.
    Taylor MA, Kaplan HS, Nelsen TS: Staging laparotomy with splenectomy for Hodgkin’s disease: the Stanford experience. World J Surg 1985, 9:449–460.PubMedCrossRefGoogle Scholar
  30. 30.
    Thibault C, Mamazza J, Letoumeau R, Poulin E: Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc 1992, 2:248–253.PubMedGoogle Scholar
  31. 31.
    Delaitre B, Maignien B: Laparoscopic splenectomy: technical aspects. Surg Endosc 1992, 6:305–308.PubMedCrossRefGoogle Scholar
  32. 32.
    Carroll BJ, Phillips EH, Semel CJ, et al.: Laparoscopic splenectomy. Surg Endosc 1992, 6:183–185.PubMedCrossRefGoogle Scholar
  33. 33.
    Lefor AT, Melvin WS, Bailey RW, Flowers JL: Laparoscopic splenectomy in the management of immune thrombocytopenia purpura. Surgery 1993, 114:613–618.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Jeffrey C. Pence
  • Keith T. Oldham

There are no affiliations available

Personalised recommendations