Abstract
Background
Laparoscopic splenectomy (LS) is significantly more challenging in patients with supramassive splenomegaly and those with portal hypertension. We hypothesized that hand-assisted laparoscopic splenectomy (HALS) could facilitate the procedure in these patients.
Methods
Before October 2009, patients with supramassive splenomegaly and those with portal hypertension underwent LS. After October 2009, we routinely applied HALS in patients with these disorders.
Results
We compared the HALS group (n = 41) with the LS group (n = 45). There were no conversions to open surgery in the HALS group, whereas there was an 4.5 % conversion rate in the LS group. The operating times were shorter, and there was less estimated blood loss, and fewer major complications in the HALS group. Analgesia requirement, time to full diet, and postoperative stay were comparable in the two groups.
Conclusions
We concluded that HALS was superior to LS in patients with supramassive splenomegaly and in those with portal hypertension.
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Acknowledgments
The study was supported by a grant by the West China Hospital, Sichuan University.
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All authors have no conflicts of interest or financial ties to disclose.
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Wang, X., Li, Y. & Peng, B. Hand-Assisted Laparoscopic Technique in the Setting of Complicated Splenectomy: A 9-Year Experience. World J Surg 37, 2046–2052 (2013). https://doi.org/10.1007/s00268-013-2114-6
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DOI: https://doi.org/10.1007/s00268-013-2114-6