Laparoscopic splenectomy in an elderly patient with splenic limphoma and splenomegaly

Materials and methods Patient of 69 years, lipothymia and anemia, Hb 11,2 gr/ dl, leukocytis 7780/dl (neutrophilis 21,4%, lymphocytis 68,9%) PLTs 81000/dl, VES 34 mm/h (n.v. 2 -28). Abdomen ultrasonography: spleen increased in volume (bipolar diameter 21,8 cm), bright liver. TC abdomen: spleen increased of volume, with inferior pole in Douglas. Medullar biopsy: NH limphoma B-cell. Patient was candidate to undergo to laparoscopic splenectomy. Laparoscopy with open technique. Section of gastric breves vessels, closure of splenic artery. Section of freno-colic and freno-lienal ligaments, section of parietal peritoneum near the spleen. Section of splenic vessels on the inferior pole and section of the grande omento. Section of splenic vein with vascular EndoGia. Legature with titanium clips and section of splenic artery. Lymph-nodes of splenic ilo are removed en-bloc with the spleen. Liver biopsy. Ombelicus-pubic laparotomy to take the specimen.