Techniques of laparoscopic morcellation of the spleen

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Abstract
Laparoscopy has recently been applied to solid organ removal. We attempted laparoscopic splenectomy in 20 selected patients with various haematologic disorders. It was performed successfully in 18 (90%) patients. The mortality was nil and the post-operative morbidity was low (17%). Splenic extraction was performed by specimen fragmentation in a plastic bag or by minilaparotomy in cases of splenomegaly or tumours of uncertain origin. One of the disadvantages of laparoscopic surgery is the removal of subsequent large solid organs. To facilitate splenic extraction, we use digital fragmentation in an impervious nylon bag and a morcellator device is not mandatory. We have widened the indications for splenic morcellation to lymphomas and Hodgkin's disease because reliable histological examination is still possible.