Laparoscopic accessory splenectomy for recurrent idiopathic thrombocytopenic purpura

This report describes the use of laparoscopic accessory splenectomy in treating recurrent idiopathic thrombocytopenic purpura (ITP). The patient presented 36 months after initial splenectomy with a platelet count of 16,000 cells/mu l and nontolerance of medical therapy. A technetium-99 labeled, heat-damaged red blood cell scan revealed two small foci in the upper left quadrant. This finding was confirmed by an abdominal computed tomography scan. After laparoscopic accessory splenectomy, the patient was discharged (23 h after surgery) and at 9 months showed a platelet count of 234,000 cells/mu l with no medical therapy. A minimally invasive approach to accessory spleen removal can be beneficial to patients with recurrent ITP and documented accessorii splenic tissue.