To investigate the application value of 3D visualization combined with 3D laparoscopy in supergiant splenectomy.

Clinical data of 1 patient with hypersplenism who underwent 3D laparoscopic supergiant splenectomy in Zhujiang Hospital of Southern Medical University in October 2019 were retrospectively analyzed. The 43-year-old female patient was admitted to hospital due to abdominal distension for 3 d. The informed consent of the patient was obtained and the local ethical committee approval was received. The spleen of the patient was significantly enlarged, the lower edge of spleen exceeded3 cm of the umbilical horizontal line and the right edge exceeded 2 cm of the anterior midline. The liver function was classified as Child-Pugh grade A. No obvious abnormality was noted in coagulation function. Enhanced CT and MRI results of the upper abdomen indicated liver cirrhosis, portal hypertension and massive splenomegaly. Before operation, thin-layer CT scan data were imported into 3D visualization system software, and a 3D model of individualized abdominal organs was constructed. The anatomical relationship of organs, the projection of spleen surface, the course of splenic artery were observed in a three-dimensional pattern. Laparoscopic splenectomy was performed under the guidance of 3D preoperative planning.

The reconstructed individualized 3D model could explicitly and stereoscopically display the course of splenic artery and vein, the morphology of splenic pedicle and the anatomical relationship between pancreatic tail and spleen. The maximal diameter of spleen was measured as 252.5 mm and the volume was 1 561 ml. Intraoperative finding was consistent with the preoperative planning. The operation was successfully completed. The operation time was 150 min, and intraoperative blood loss was 50 ml. No postoperative complications, such as abdominal hemorrhage, pancreatic fistula and incisional infection, occurred.

3D visualization helps to make the accurate preoperative planning. 3D laparoscopic splenectomy is safe and feasible when combining with 3D visualization.