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Single-incision laparoscopic splenectomy: preliminary experience in consecutive patients and comparison to standard laparoscopic splenectomy

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Abstract

Background

Since first being described in 2009, single-incision laparoscopic splenectomy has been described in a limited number of case reports and small case series. No studies have evaluated single-incision splenectomy in unselected patients, and outcomes of the procedure have not previously been compared to standard laparoscopy.

Methods

A retrospective review was conducted to evaluate all single-incision splenectomies performed by a single surgeon between June 2010 and June 2011. Additionally, patients who underwent standard laparoscopic splenectomy by surgeons in the same tertiary referral surgical oncology group were evaluated to serve as a control group. Demographic data, operative parameters, and postoperative outcomes were assessed.

Results

Eight patients underwent successful single-incision splenectomy during the study period without conversion to an open procedure or requiring additional ports. The median operative time was 92.5 min. There was 25 % morbidity and no mortality in the study group. Median length of stay was 4 days. Additionally, 18 patients who underwent standard laparoscopic splenectomy were evaluated for comparison. No significant differences were identified in the preoperative patient characteristics between the two groups. Single-incision splenectomy was associated with a shorter operative time (92.5 vs. 172 min, p = 0.003), lower conversion rate, equivalent length of stay, reduced mortality, similar morbidity, and comparable postoperative narcotic requirements.

Conclusions

Single-incision splenectomy is feasible, safe, and efficient in an unselected patient population in the hands of an experienced laparoscopic surgeon. The single-incision technique is comparable to standard laparoscopic splenectomy in terms of operative time and perioperative outcomes.

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Disclosures

B. A. Boone, P. Wagner, E. Ganchuk, L. Evans, S. Evans, H. J. Zeh, D. L. Bartlett, and M. P. Holtzman have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, University of Pittsburgh Medical Center, 5150 Centre Ave., Suite 420, Pittsburgh, PA, 15232, USA

    Brian A. Boone, Patrick Wagner, Emily Ganchuk, Leonard Evans, Steven Evans, Herb J. Zeh, David L. Bartlett & Matthew P. Holtzman

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  1. Brian A. Boone
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  2. Patrick Wagner
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  3. Emily Ganchuk
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  4. Leonard Evans
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  8. Matthew P. Holtzman
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Correspondence to Matthew P. Holtzman.

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Boone, B.A., Wagner, P., Ganchuk, E. et al. Single-incision laparoscopic splenectomy: preliminary experience in consecutive patients and comparison to standard laparoscopic splenectomy. Surg Endosc 27, 587–592 (2013). https://doi.org/10.1007/s00464-012-2494-y

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  • DOI: https://doi.org/10.1007/s00464-012-2494-y

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