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Details of surgical procedure: a) laparoscopic exploration with identification of voluminous lesion in the upper pole of the spleen; b) clipped splenic artery (arrow) and splenic vein (dashed arrow); c-d) ischemic parenchyma demarcation zone treated with monopolar hook.
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Into peritoneal cavity we found the already known voluminous lesion of 10 cm in the upper pole of the spleen (Fig. 1).
Details of surgical procedure: a-b) dissection of splenic parenchyma with Harmonic device; c-d) use of warm saline solution in order to improve coagulation and reduce the fog of operating field.
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Ischemic parenchyma demarcation zone allowed us to carry out a precise splenic transection with Harmonic device and bipolar forceps (Fig. 2).
a) the results at the end of surgical procedure; b-c-d) use of the haemostatic matrix (Floseal ) above the residual spleen that was put into its natural cavity using fibrin sealant.
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At the end of procedure we also used haemostatic matrix (Floseal) above the residual spleen that was put into its natural cavity using fibrin sealant (Fig. 3).