Laparoscopic Splenectomy Using a Low-pressure Pneumoperitoneum for the Treatment of Immune Thrombocytopenic Purpura During Pregnancy : A Case Report

Koji KUBOTA; Akira KOBAYASHI; Takahide YOKOYAMA; Norihiko KIKUCHI; Noriyuki KITAGAWA; Norihiko FURUSAWA; Hiroaki MOTOYAMA; Akira SHIMIZU; Tanri SHIOZAWA; Shin-ichi MIYAGAWA

doi:10.11441/shinshumedj.62.441

Case Report

Laparoscopic Splenectomy Using a Low-pressure Pneumoperitoneum for the Treatment of Immune Thrombocytopenic Purpura During Pregnancy : A Case Report

Koji KUBOTA, Akira KOBAYASHI, Takahide YOKOYAMA, Norihiko KIKUCHI, Noriyuki KITAGAWA, Norihiko FURUSAWA, Hiroaki MOTOYAMA, Akira SHIMIZU, Tanri SHIOZAWA, Shin-ichi MIYAGAWA

Author information

Koji KUBOTA
Department of Surgery, Shinshu University School of Medicine
Akira KOBAYASHI
Department of Surgery, Shinshu University School of Medicine
Takahide YOKOYAMA
Department of Surgery, Shinshu University School of Medicine
Norihiko KIKUCHI
Department of Obstetrics and Gynecology, Shinshu University School of Medicine
Noriyuki KITAGAWA
Department of Surgery, Shinshu University School of Medicine
Norihiko FURUSAWA
Department of Surgery, Shinshu University School of Medicine
Hiroaki MOTOYAMA
Department of Surgery, Shinshu University School of Medicine
Akira SHIMIZU
Department of Surgery, Shinshu University School of Medicine
Tanri SHIOZAWA
Department of Obstetrics and Gynecology, Shinshu University School of Medicine
Shin-ichi MIYAGAWA
Department of Surgery, Shinshu University School of Medicine

Keywords: pregnancy, immune thrombocytopenic purpura, laparoscopic splenectomy, low-pressure pneumoperitoneum

JOURNAL FREE ACCESS

2014 Volume 62 Issue 6 Pages 441-446

DOI https://doi.org/10.11441/shinshumedj.62.441

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Abstract

We report the case of a 21-year-old pregnant woman who underwent a laparoscopic splenectomy for the treatment of immune thrombocytopenic purpura (ITP) because of severe thrombocytopenia refractory to medical therapy using steroids. The operation was performed during the 24^th week of pregnancy using a rigid 10-mm scope with adjustable viewing angles and limiting the abdominal insufflation pressure to 8mmHg. The operating time was 204 minutes, and the amount of intraoperative blood loss was 200mL. Her postoperative course was uneventful, and her platelet count rapidly increased postoperatively. No additional treatments were required.

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