Aydın YAĞMURLU, Hüseyin DİNDAR, Suat FİTÖZ, Rahşan VARGÜN, Bilal ALPER

Büyük dalağı olan çocuk hastalarda da laparoskopik splenektomi yapılabilir: Bir olgu sunumu

Herediter Sferositoz nedeniyle splertektomi; endikasyonu konulan 13 yaşındaki erkek çocuğun yapılan ultrasortografik ve manyetik rezonans görüntüleme,incelemelerinde,dalağın 16.5x7x6.5 cm boyutlannda olduğu saptandı; Dört-trokar kullanılarak yapılan laparoskopik splenektomide, dalağın karın dışına çıkarılması sırasında sol alt kadrandaki 12 mm'lik trokar giriş yeri 1,5 em'ye büyütülerek/derinliği 20 cm genişliği 10 cm olan mekanik olarak,daha dayanıklı çıkartıcı torba karın içine ilerletildi. Torba içine alınan dalak, parmakla parçalanarak çıkartıldı. Eş zamanlı olarak safra kesesindeki taşlar nedeniyle laparoskopik kolesistektomi de yapıldı. Laparoskopik splenektomi, büyük dalaklarda bile uygun malzeme seçimi ve iyi teknik yaklaşımla güvenli olarak yapılabilmektedir.

Laparoscopic splenectomy can be performed in pediatric patients with huge spleen: A case report

Splenectomy was planned In a 13 years-old boy with hereditary spherocytosis. Ultrasonography and Magnetic Resonance Imaging revealed a 16.5x7x6.5 cm. sized spleen. During the extripation of the spleen, 12 mm. trocar site in left lower quadrant was extented up to 1.5 cm. A mechanically stronger endobag with a depth of 20 cm, and a width of 10 cm. was inserted. It was morcellated using fingers and then extripated. Laparoscopic cholecystectomy was performed concomitantly for cholelithiasis.Even in vigorous splenomegaly, laparoscopic splenectomy can safely be performed with proper equipment usage and good technical approach.

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