Laparoscopic Splenectomy and Splenic Artery Exclusion for Multiple Splenic Artery Aneurysms

Abstract

Introduction:

There are numerous management options for splenic artery aneurysms, including observation, interventional vascular embolization, and surgical intervention. ^{1 –5} Management strategies can vary based on size, location, and number of aneurysms present. While aneurysms of the splenic artery that occur in the splenic hilum are easily managed by laparoscopic splenectomy, the presence of multiple or more proximal aneurysms present a special challenge that is not addressed completely by splenectomy. In this video (7 min 27 sec), we show the case of a patient with a 2-cm proximal splenic artery aneurysm that was 5 cm proximal to the hilum, and two concomitant splenic hilum aneurysms.

Materials and Methods:

Depicted is the technique for laparoscopic exclusion of a more proximal aneurysm verified with intraoperative ultrasonography, and laparoscopic splenectomy to address the splenic hilum aneurysms.

Results and Conclusions:

Management options for splenic artery aneurysms vary; however, the presence of multiple aneurysms in different locations limits the feasibility of less invasive techniques like embolization because of the inability to achieve complete isolation of all of the aneurysms. The use of laparoscopy, including laparoscopic intraoperative ultrasonography to confirm aneurysm exclusion, should be considered a preferred approach in the setting of multiple splenic artery aneurysms.

No competing financial interests exist.

Runtime of video: 7 mins 27 secs