how is spleenectomy performed in surgical emergencies?

Question

i am a resident doctor in general surgery and would like to know how to perform removal of raptured spleen to secure hemostasis.

Answer 1

http://pediatrics.aappublications.org/cgi/content/full/111/6/1239

Answer 2

If the spleen's already been "raptured" I'm sure the patient's been raptured, too and you won't have to worry (unless you're "left behind") - lol

If you're looking for a premium on-line site try www.mdconsult.com. There are books and journals to take you step by step.

First, treat the patient, not the organ. 2-large bore IVs, ABCs, NG, Foley etc. Then consider whether the splenic rupture can be surgically repaired or if it must be removed (severity of injury, associated injuries, age, personal experience)

In a true trauma emergency use a midline incision; otherwise consider smaller left subcostal (or even laparoscopic). The details of the resection are best understood with a picture book (e.g. Khatri's Surgical Manual). Let's say you properly remove all the attachments then you're ready to answer your question about hemostasis. You can use lap pads throughout the procedure to help rotate the spleen forward for visualization and help with the bleeding. The only major artery is the splenic artery, which needs to be identified, dissected doubly ligated and divided. A similar technique should be used for the splenic vein. Do the gastrosplenic ligament last and identify the short gastric vessels and any gastroepiploics before you just cut through. Examine the surrounding organs, clean up and close.

Answer 3

You are a dumbass with no training at all, and I'm surprised you know how to spell hemostasis, let alone what it is.

Answer 4

Who are you fooling if your a resident doctor you should have assisted in this process already as part of your training. Go down to the morgue if you need pratice.

Answer 5

Are you a doctor? If you are, I hope you are not in my area!