Article Abstract

Laparoscopic splenopexy utilizing an extraperitoneal pocket for symptomatic wandering spleen

Authors: Aqsa Shakoor, Jennifer DeFazio, Ariela Zenilman, Linda Li, Vincent P. Duron

Abstract

Wandering spleen is a rare clinical entity characterized by an ectopic spleen. The mobile spleen can easily torse around its vascular pedicle, placing the patient at risk of acute infarction of the organ. The treatment for a wandering spleen is surgical with options including splenopexy or splenectomy. We report the case of a 10-year-old child with imaging proven wandering spleen successfully treated with splenopexy using a novel technique involving both the creation of a pre-peritoneal pocket and a small mesh. The use of an extra-peritoneal pouch poses the benefits of minimizing intra-abdominal dissection. We think this combination technique is advantageous for several reasons: (I) it allows for a completely blunt dissection of the pouch without the use of laparoscopic graspers; (II) the creation of the pouch in line with the layers of the abdominal wall maintains the integrity of the peritoneum without weakening or tearing it; (III) this technique offers relative ease and speed since the surface area of the tools used is wider and less traumatic than laparoscopic instruments. Laparoscopic splenopexy utilizing an extraperitoneal pocket for asymptomatic wandering spleen is a safe and efficacious surgical option.