Application of Microwave Ablation in Laparoscopic Partial Splenectomy

Summary

The use of laparoscopic partial splenectomy has been limited due to the high risk of bleeding during surgery. Therefore, we introduce a laparoscopic method combined with microwave ablation to solve the problem of intraoperative bleeding.

Abstract

Splenic hemangioma is the most common pathological classification of splenic tumors, and its surgical indication and treatment have been controversial. Before, open splenectomy was usually used to treat splenic hemangioma. Following the rapid development of laparoscopic techniques, people's requirements for minimally invasive treatment have gradually increased, and laparoscopic splenectomy has gradually become the main treatment method. However, through the deeper study of spleen function, it was found that partial splenectomy can cut down the incidence of postoperative thrombocythemia and decrease side effects on the physiological function of the body, so laparoscopic partial splenectomy came into being. However, due to the special anatomical structure, the incidence of hemorrhage during partial splenectomy is greater. Therefore, during the operation, we removed part of the splenic blood vessels, combined with microwave ablation, which perfectly solved the problem of intraoperative bleeding. Laparoscopic partial splenectomy combined with microwave ablation not only achieves the requirements of minimally invasive treatment but also reduces the risk of intraoperative bleeding, meriting clinical application and promotion.

Introduction

Benign splenic lesions generally do not require surgical intervention, and regular follow-up is the mainstay. Surgery is indicated when they become larger than 40 mm in diameter or cause clinical symptoms¹. For benign splenic mass lesions, total splenectomy is the mainstay of surgery, and laparoscopic total splenectomy (LTS) has long been considered a standard surgical procedure. The advantages of this technique over open surgery are indisputable². However, total splenectomy can lead to complications such as decreased immunity, venous thrombosis, and infection after overwhelming splenectomy^3,....

Protocol

This protocol meets the norms and requirements of the Medical Ethics Committee of the First Affiliated Hospital of Jinan University, and the informed consent of the patient has been obtained.

1. Preoperative examination

1. Determine the location and size of the tumor and blood vessels (Splenic arteriovenous branches) supplying the tumor according to the preoperative CT or MRI, and then plan the resection range and microwave ablation plane. Here, only an MRI was perfor.......

Discussion

The selection of appropriate cases is the first step in the successful development of LPS. Based on personal experience and literature reports, we summarize the following indications^14,15: (1) The tumor is located in the upper or lower pole of the spleen and away from the splenic hilum. (2) There is no serious adhesion between the tumor and surrounding tissues. (3) The retained spleen volume should be at least 25% of the original volume. (4) No coagulation dysfun.......

Materials

Name	Company	Catalog Number	Comments
10-mm trocar	Xiamen Surgaid Medical Device Co., LTD	NGCS 100-1-10	Sterile, ethylene oxide sterilized, disposable
12-mm trocar	Xiamen Surgaid Medical Device Co., LTD	NGCS 100-1-12	Sterile, ethylene oxide sterilized, disposable
5-mm trocar	Xiamen Surgaid Medical Device Co., LTD	NGCS 100-1-5	Sterile, ethylene oxide sterilized, disposable
Hem-o-lok	America Teleflex Medical Technology Co., LTD	544240	Sterile, ethylene oxide sterilized, disposable
Pneumoperitoneum needle	Xiamen Surgaid Medical Device Co., LTD	NGCS 100-1	Sterile, ethylene oxide sterilized, disposable
Suction and irrigation tube	Tonglu Hengfeng Medical Device Co., LTD	HF6518.035	Sterile,dry heat sterilized, reusable
Ultrasounic-harmonic scalpel	Chongqing Maikewei Medical Technology Co., LTD	QUHS36S	Sterile, ethylene oxide sterilized, disposable
Water-cooled microwave ablation probe(single use)	Nanjing Viking Jiuzhou Medical Device R&D Center	MTC-3CA-II19	Sterile, ethylene oxide sterilized, disposable