Laparoscopic splenectomy

Laparoscopy not only confirms the diagnosis, but also facilitates the determination of the degree of spleen injury. In the past, due to the one-sided view that "the spleen is not an essential organ for life," splenectomy is the only option for the treatment of various types of spleen rupture. However, the spleen has multiple functions, especially the understanding of the risk of sinister infection (OPSI) after splenectomy, which has gradually formed the concept of preserving the spleen. Treatment of diseases: spleen trauma in children Indication Laparoscopic spleen preservation is mainly applied to patients with abdominal closed injury who have mild spleen injury, hemodynamic stability, no complex or multiple organ damage, which is mild in age, clinical manifestations and related examinations. Contraindications It is unwise to use laparoscopic spleen to stop bleeding for spleen rupture of grade IV or above with severe injury and large amount of bleeding. The success rate of surgery is extremely low. Preoperative preparation Gastrointestinal decompression should be performed before operation. For patients with esophageal varices, soft stomach tube should be selected. A small amount of liquid paraffin should be taken before the lower tube. Pay special attention to prevent major bleeding. Blood should be prepared before surgery to prepare for blood transfusion. Sufficient antibiotics should also be given. At the same time, attention should be paid to the multiple injuries of other organs and given treatment. Sufficient antibiotics should be given to prevent infection. When the preoperative preparation is basically completed and the surgical instruments are ready, the operation should be stopped as soon as possible under anti-shock treatment, and should not wait for shock to correct. Surgical procedure Conventional carbon dioxide continues to pneumoperitoneum, the pressure is maintained at 12 ~ 14mmHg, first understand the extent of spleen damage and other organs in the abdomen, and then absorb the blood around the spleen, revealing the spleen. For the rupture of grade I and II, bio-gel spray, electrocoagulation and hemostasis can be used to stop bleeding. For grade III spleen rupture, comprehensive hemostasis should be used, and the vascular omentum can be filled in the rupture. Stitching. After hemostasis, observe for 15 minutes. If there is no bleeding, place a drainage tube around the spleen and end the operation.

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