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    The incidence of splenic hemangioma and its rupture risk
    (2018) Gündoğan, Ersin; Şansal, Müfit; Gunes, Orgun; Akinci, Eray Can; Erkenekli, Tarik Emre; Sümer, Fatih; Kutlu, Ramazan; Kayaalp, Cüneyt
    Abstract: Aim: The incidence of splenic hemangioma was reported in a wide range (0.03-14%) based on the autopsy data between the years of 1895-1965. The suggested treatment in an early systematic review was routine splenectomy due to the fear of splenic rupture. We aimed to determine the incidence of splenic hemangiomas in the modern imaging era, to evaluate the rupture risk and the necessity of splenectomy for every splenic hemangioma. Material Method: Between January and December 2016, the reports of all patients who had any abdominal imaging modalities in our hospital were electronically scanned for splenic hemangiomas. Repeated examinations were excluded. Age, gender, reason of radiological examination, imaging modality, number and the size of the splenic hemangiomas, hematological test and the follow-up results were evaluated. Results: Total 31 of 30,021 (0.1%) patients with abdominal imaging examinations were diagnosed as splenic hemangioma. Fiftyeight percent were female and the mean age was 50.1±15.4 (median and range, 52 and 12-75). Only two referred with abdominal pain but the pain localizations were incompatible with hemangiomas. Mean hemoglobin values were found to be 13.2±2.2 gr/dl and platelet counts were found to be 249.300±115.800. The dimensions of the detected lesions were mean 13.1± 8.1mm (median 1, range 0.5-4.5 cm) and only one patient had multiple involvement. Splenic rupture was detected in a patient with chronic renal failure and splenectomy was performed. Conclusion: Routine splenectomy for <4.5 cm splenic hemangiomas is not essential but longer follow-up is required. More studies for 4.5 cm< splenic hemangiomas are necessary.
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    Laparoscopic sleeve gastrectomy technique: How we do it
    (2018) Şansal, Müfit; Sağlam, Kutay; Gökler, Cihan; Sümer, Fatih; Kayaalp, Cüneyt
    A total of 1002 bariatric procedures were performed at our clinic between March 2006 and December 2016.The laparoscopic Roux-en-Y gastric bypass (LRYGB) technique was performed on 833 patients. Three ofthe LRYGB procedures were revisions of a previous laparoscopic sleeve gastrectomy (LSG). In 169 patients,the sleeve gastrectomy technique was used. One procedure was performed via laparotomy, but the otherswere performed laparoscopically. Six patients’ sleeve gastrectomy lines were transected and sutured usinga laparoscopic needle holder, while the others were closed with a stapling device. Ileojejunal bypass wasadded in 21 of the LSG procedures. This clinic’s experience with morbid obesity surgery began with opengastric bypass surgery and later evolved into use of the LRYGB method. Sleeve gastrectomy, which is popular in this country and around the world, has been performed since July 2014 (handmade as of May). Thisarticle describes some of the nuances and subtleties of the LSG technique.