الفهرس 
Anatomy of the spleenOnly 14 pages are availabe for public view
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Abstract
Laparoscopic splenectomy is feasible, effective, and safe with low morbidity rates and has rapidly become the surgical approach of choice for patients that require elective splenectomy in the treatment of hematologic disorders. Stapling devices have been established as a mainstay in laparoscopic splenectomy. Material and methods: The study was conducted in Fayoum University Hospitals from November 2014 till July 2016 and it included twenty patients in whom splenectomy was indicated. All patients were subjected to laparoscopic splenectomy with sealing of the pedicle using LigaSure and harmonic scalpel. Results: The patients were presented by different indications for splenectomy , 8 cases of hemolytic anemia , 6 cases of hypersplenism , 4 cases of ITP and 2 cases of splenic focal lesions . The intraoperative bleeding ranged from 50 ml to 250 ml on average 150 ml. The conversion rate was 10 %. The operating time ranged from less than one hour to three hours. Spleens were extracted out of the abdomen via a small pfannenstiel incision in all cases except the two cases which were converted to open technique. Patients were discharged from the hospital on the 3rd post-operative day (13 cases), (4 cases) were discharged on the 4th day and three cases were discharged after 7 days. Conclusion: Stapleless and sutureless laparoscopic splenectomy for splenomegaly is safe and effective, and it is associated with low conversion rates in selected patients. This technique reduces operating time in laparoscopic splenectomy and removes the disadvantage of a longer operating period in laparoscopic splenectomy over the open splenectomy with acceptable complication and conversion rates The technique may be considered an alternative when it is difficult or inadequate to use mechanical stapling devices to transect the splenic hilum. Furthermore work is needed to demonstrate all the advantages and disadvantages of using vessels sealing devices in laparoscopic splenectomy without the use of staples or sutures.