Laparoscopic splenectomy for chronic idiopathic thrombocytopenic purpura.

Since October 1994, we have performed 15 laparoscopic splenectomies for idiopathic thrombocytopenic purpura. All the patients were women, aged 23 to 47 years. We used five ports (three 10-mm ports and two 5-mm ports) for the first eight cases, but we could save one 10-mm port after changing patient's position from supine to the right lateral kidney position. There was no case of conversion to exploratory laparotomy. The mean hospital stay was 6 days. No significant perioperative morbidity or mortality was associated with the surgery. Since undergoing laparoscopic splenectomy, 12 patients have been off steroids, two patients have been on small doses of steroids, and one patient has been on the same dose of steroid with no response. Laparoscopic splenectomy is a relatively safe and reasonable operative procedure for the patient with idiopathic thrombocytopenic purpura or normal-sized spleen.