Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic Splenectomy According to Spleen Size: a 19 Years’ Experience Study of a Single Institution

  • Surgical Techniques and Innovations
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

The laparoscopic approach is commonly used when splenectomy is required. The aim of this study is to present our department’s 20 years of experience in laparoscopic splenectomy, with emphasis to the technique employed according to spleen size. We have analyzed our department’s data concerning laparoscopic splenectomy (LS) from January of 2000 until January of 2019. During this time, 119 laparoscopic splenectomies were performed. Ninety-three procedures were categorized as total laparoscopic splenectomies (TLS) and 26 as hand-assisted laparoscopic splenectomies (HALS). In addition, during the same period, 115 patients underwent open splenectomy (OS). Conversion to open splenectomy was necessary in 11 (9.24%) cases. There were 5 (4.2%) cases of postoperative bleeding. A complication rate of 8.4% after LS is to be reported. In our series there was 1 death (0.84%). We performed LS in 78 patients with immune thrombocytopenia (ITP) with a remission rate of 84%. LS is a widely used procedure, even in patients with ITP who present with low platelet count. An experienced surgeon can perform LS even in large spleens.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Delaitre B, Maignien B, Icard P (1992) Laparoscopic splenectomy. Br J Surg 79(12):1334–1334

    Article  CAS  Google Scholar 

  2. Katkhouda N et al (1998) Laparoscopic splenectomy: outcome and efficacy in 103 consecutive patients. Ann Surg 228(4):568

    Article  CAS  Google Scholar 

  3. Feldman LS (2011) Laparoscopic splenectomy: standardized approach. World J Surg 35(7):1487–1495

    Article  Google Scholar 

  4. Bo C et al (2008) Laparoscopic splenectomy: a 12-year single-center experience. Chin Med J 121(8):766–768

    Article  Google Scholar 

  5. Stanton C (1999) Laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP). Surg Endosc 13(11):1083–1086

    Article  CAS  Google Scholar 

  6. Feldman LS et al (2008) Refining the selection criteria for laparoscopic versus open splenectomy for splenomegaly. J Laparoendosc Adv Surg Tech 18(1):13–19

    Article  Google Scholar 

  7. Maurus CF et al (2008) Laparoscopic versus open splenectomy for nontraumatic diseases. World J Surg 32(11):2444–2449

    Article  Google Scholar 

  8. Smith L et al (2004) Laparoscopic splenectomy for treatment of splenomegaly. Am J Surg 187(5):618–620

    Article  Google Scholar 

  9. Bresler L et al (2002) Laparoscopic splenectomy for idiopathic thrombocytopenic purpura: outcome and long-term results. World J Surg 26(1):111

    Article  Google Scholar 

  10. Targarona EM et al (2000) Complications of laparoscopic splenectomy. Arch Surg 135(10):1137–1140

    Article  CAS  Google Scholar 

  11. Habermalz B et al (2008) Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc 22(4):821–848

    Article  CAS  Google Scholar 

  12. Tsamalaidze L et al (2017) Laparoscopic Splenectomy for Massive Splenomegaly: Does Size Matter? J Laparoendosc Adv Surg Tech A 27(10):1009–1014

    Article  Google Scholar 

  13. Shin RD et al (2019) Laparoscopic versus open splenectomy for splenomegaly: the verdict is unclear. Surg Endosc 33(4):1298–1303

    Article  Google Scholar 

  14. Podevin G et al (2011) Laparoscopic splenectomy: comparison between anterior and lateral approaches. J Laparoendosc Adv Surg Tech A 21(9):865–868

    Article  Google Scholar 

  15. Kavic S, Segan R, Park A (2005) Laparoscopic splenectomy in the elderly: a morbid procedure? Surg Endosc Other Interv Tech 19(12):1561–1564

    Article  CAS  Google Scholar 

  16. Grahn SW, Alvarez J, Kirkwood K (2006) Trends in laparoscopic splenectomy for massive splenomegaly. Arch Surg 141(8):755–762

    Article  Google Scholar 

  17. Owera A et al (2006) Laparoscopic versus open splenectomy for massive splenomegaly: a comparative study. J Laparoendosc Adv Surg Tech A 16(3):241–246

    Article  Google Scholar 

  18. Park AE et al (2000) Laparoscopic splenectomy: outcomes and lessons learned from over 200 cases. Surgery 128(4):660–667

    Article  CAS  Google Scholar 

  19. Flowers JL et al (1996) Laparoscopic splenectomy in patients with hematologic diseases. Ann Surg 224(1):19

    Article  CAS  Google Scholar 

  20. Torelli P et al (2002) Laparoscopic splenectomy for hematological diseases. Surg Endosc Interv Tech 16(6):965–971

    Article  CAS  Google Scholar 

  21. Keidar A, Feldman M, Szold A (2005) Analysis of outcome of laparoscopic splenectomy for idiopathic thrombocytopenic purpura by platelet count. Am J Hematol 80(2):95–100

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Third Surgical Department, “Evangelismos” General Hospital of Athens, Athens, Greece

    Stylianos Kapiris, Panagiotis Metaxas, Georgia Paraskevakou, Paraskevi Alexakou, Maria Sotiropoulou, Michail Psarologos, Charilaos Kyzeridis, Eleni Mavrodimitraki, Ageliki Kolinioti & Ioannis Alevizakis

Authors
  1. Stylianos Kapiris
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Panagiotis Metaxas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Georgia Paraskevakou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paraskevi Alexakou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Sotiropoulou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michail Psarologos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Charilaos Kyzeridis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Eleni Mavrodimitraki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ageliki Kolinioti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ioannis Alevizakis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Panagiotis Metaxas.

Ethics declarations

Disclosure Statement

No competing financial interests exist.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kapiris, S., Metaxas, P., Paraskevakou, G. et al. Laparoscopic Splenectomy According to Spleen Size: a 19 Years’ Experience Study of a Single Institution. Indian J Surg 84, 1062–1066 (2022). https://doi.org/10.1007/s12262-021-03114-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-021-03114-4

Keywords

Search

Navigation