Splenic Surgery

Abstract

Splenectomy is a very common surgical procedure. Indications for splenectomy vary, therefore the operative steps, difficulty and post-operative results differ. With the development of laparoscopic surgical technique and improvement of surgical instruments, single-incision laparoscopic splenectomy has been used in clinic. Barbaros U et al. reported the index case of laparoendoscopic single-site splenectomy in 2009 (Barbaros and Dinççağ, Gastrointest Surg 13:1520–1523, 2009). Thereafter, this procedure has been adapted in clinical practice by some institutions (Vatansev and Ece, Surg Laparosc Endosc Percutan Tech 19:e225–e227, 2009; Malladi et al., JSLS 13:601–604, 2009; Lagrand and Kehdy, Am Surg 76:E158–E159, 2010; Barbaros et al., Surg Laparosc Endosc Percutan Tech 20:306–311, 2010; Colon et al., JSLS 15:384–386, 2011; Bell et al., J Pediatr Surg 47:898–903, 2012; Dapri et al., Surg Endosc 25:3419–3422, 2011). We have reported the first case of laparoendoscopic single-site splenectomy in the treatment of traumatic rupture of the spleen in 2011 (Fan et al., Surg Innov 18:185–188, 2011) and hypersplenism secondary to portal hypertension in 2012 (Jing et al., Surg Innov, 2012).

We believe, in early series of highly selected patients, laparoendoscopic single-site splenectomy appears to be feasible and safe when performed by experienced laparoscopic surgeons. Despite technical difficulties, there may be potential benefits associated with single-incision over multiple-incision laparoscopic splenectomy but it is yet to be proven objectively.