Laparoscopic transperitoneal left adrenalectomy and wandering spleen risk.

Piccoli, Micaela; De Luca, Giuseppe Massimiliano; Pasculli, Alessandro; Angelini, Marta; Guicciardi, Lorenzo; Mullineris, Barbara; Marchi, Domenico; Melotti, Gianluigi

BACKGROUND AND OBJECTIVES Laparoscopic transperitoneal left adrenalectomy (LTLA) has become the standard treatment for adrenal masses<6 cm. LTLA involves the dissection of splenic suspensory ligaments, which replicates their congenital absence or weakening, present in cases of wandering spleen (WS). WS is a rare condition in which the spleen migrates from the left upper quadrant to a more caudal location in the abdomen. A unique case of WS after LTLA was described by Corcione et al. In this prospective study, we investigated the possibility of WS as a consequence of LTLA. METHODS Twenty-four patients, 8 men and 16 women, who underwent LTLA with the dissection of splenoparietal and splenorenal ligaments were selected. RESULTS Clinical and ultrasonographic follow-up showed no evidence of postoperative WS. CONCLUSIONS In the literature, WS is not commonly reported as a postoperative complication of LTLA. In effect, especially in the case of small adrenal masses, the spleen's repositioning in its seat is autonomous. However, the alarming possibility of WS should not be ignored, especially in the case of extensive dissection of the left colic flexure. It would be useful for other authors to signal this complication, so that different approaches and consequent results may be compared.