Pupose: To eyaluate the usefulness of laparoscpic splenectomy in idiopathic thrombocytopentic prupara(ITP).

Patients and Methods: The anthors reviewed 15 cases of laparoscopic splenectomy for idiopathic thrombocytopenic purpura between September 1998 and May 2001. There were 3 males and 12 fenales, and the mean age was 30.8 years. We used 4 ports(two 5mm ports, two 12mm ports) for all case with modified right lateral kidney position under carbon dioxide pneumoperitoneum. The vascular control was achieved using Harmonic Scalpel, endovascular clips and EndoGIA in a few case. For the removal of the dissected spleen, an Endopouch was introduced into the peritoneal cavity and the spleen was placed in the bag. Piecemeal removal of conversion to open laparotomy.

Results: The mean operation time was 225.3 min; 258min in first half and 209min in second half. The mean estimated bleeding amount was 145.5cc. Median postoperative hospital stay was 7 days. In only one case, second operation of recurrent ITP was done because accessory spleen was found by postoperative spleen scan. 12 patients(80%) of complete response had been off steroids with platelet counts greater than 100.000/㎣.

Cinclusion: Lapatoscopic splencetomy is a relative safe and reasonable operative procedure for the patients with ITP

Keywords: ITP, Laparoscopy, Splenectomy