Hand-assisted laparoscopic partial splenectomy using an endopath monopolar sealer.

A partial splenectomy is a good way to prevent postsplenectomy infections by preservation of the immune role of the spleen for select patients. Although a laparoscopic total splenectomy is a safe and feasible treatment modality, the laparoscopic approach has not been generally adopted for a partial splenectomy because of technical difficulties. The hand-assisted technique provides an excellent means to explore, to retract safely, and to apply immediate hemostasis in solid organ resection. The hand-assisted laparoscopic partial splenectomy using an endopath monopolar sealer (Salient EndoSH2.0 Monopolar Sealer) was performed successfully. The segmental arteries and veins were isolated and divided using a tactile feedback. Splenic parenchyma was dissected and sealed using an endopath monopolar sealer. The surgical field was almost bloodless during the parenchymal transection and the transection time was around 15 minutes. The hand-assisted laparoscopic approach allows partial splenectomy as a safe and bloodless surgery for select patients.