During Laparoscopic transabdominal left adrenalectomy (LTLA) a greater mobilization of the pancreaticosplenic would have recreated the conditions of a wandering spleen (WS) manifested by its complication. The aim of this study is to determine whether the mobilization of the spleen during LTLA, could be recognized as a cause of postoperative WS.

Between January 2008 and December 2023, 64 patients who underwent LTLA with the dissection of splenoparietal and splenorenal ligaments, were selected. Before and 6 months after surgery a clinical and instrumental follow-up [ultrasound (US)] were performed in order to verify the possible presence of a wandering spleen.

The average operation length was 102 ± 30 min. During the US protocol, no significant difference in the pre- and postoperative longitudinal diameter of the spleen was observed (p = 0.531), neither anteroposterior diameter of the spleen nor the resistive index was significantly different in these reports, confirming normal position of the spleen with normal blood flow in the supine position, in the right lateral position, and in orthostatism; an absence of spleen mobilization related to the diaphragmatic dome; and an absence of collections.

Our experience does not exclude the occurrence of a wandering spleen, but allows us to state that a rightful mobilization of the pancreaticosplenic block can avoid this event, and in agreement with other authors, the presence of a wandering spleen remains an isolated complication. However, the alarming possibility of WS should not be ignored, especially in the case of extensive dissection of the left colic flexure.