• Nicola Basso, Gianfranco Silecchia, Luigi Raparelli, Gennaro Pizzuto, and Tullio Picconi.
• Department of Surgery P. Stefanini, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy.
• J Laparoendosc Adv Surg Tech A. 2003 Apr 1;13(2):109-12.

AbstractSplenic rupture is a frequent consequence of blunt abdominal trauma. When nonsurgical management is not indicated, splenic rupture is usually an emergency requiring surgery. Removal of the spleen (splenectomy) or alternative conservative procedures (splenorraphy, partial splenectomy, and hemostatic collagen application) are surgical treatment options. Recently, laparoscopic conservative techniques have been proposed. Laparoscopic splenectomy for a ruptured spleen has been reported only in a single case, in which a hand-assisted technique was used. We present the first reported case, to our knowledge, of successful removal of a ruptured spleen by means of a totally laparoscopic technique. Adequate technical instrumentation, such as the endostapler, harmonic scalpel, and red cell-saving machine, in addition to extensive experience with routine splenectomy, were essential factors to ensure a safe and effective procedure.

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