Use of Nathanson retractor during laparoscopic splenectomy for supermassive spleens.

BACKGROUND

Although feasibility of laparoscopic splenectomy for supermassive spleens has been described, obtaining uniform and uninterrupted retraction of a heavy spleen to ensure safe hilar dissection is challenging. We describe a technique of retraction of supermassive spleens using a Nathanson retractor.

METHODS

This technique was used in 4 patients, and the demographic data as well as data related to the surgery were retrospectively collected.

RESULTS

The spleens weighed between 2.5 and 3.5 kg. The median operative time was 190 minutes (155-220 min) and the median intraoperative blood loss was 870 mL (600-1230 mL). The postoperative hospital stay ranged from 3 to 5 days.

CONCLUSIONS

A Nathanson retractor provides sustained retraction of a supermassive spleen during laparoscopic splenectomy and this technique should be considered a useful adjunct to the armamentarium of surgeons undertaking these challenging procedures.