Laparoscopic near-total splenectomy: a single-center experience of a standardized procedure. Issue 5 (3rd September 2019)

• Record Type: Journal Article
• Authors: Tartaglia, Ernesto; Reggio, Stefano; Cuccurullo, Diego; Fabozzi, Massimiliano; Sagnelli, Carlo; Miranda, Lucia; Corcione, Francesco
• Is Part Of: Minimally invasive therapy & allied technologies. Volume 28:Issue 5(2019)
• Page Start: 298
• Page End: 303
• Publication Date: 2019-09-03
• Subjects: splenectomy -- near-total splenectomy -- laparoscopic -- surgical technique; Endoscopy -- Periodicals; Interventional radiology -- Periodicals; Endoscopic surgery -- Periodicals; 617.05
• DOI: 10.1080/13645706.2018.1521433
• Languages: English
• ISSNs: 1364-5706

Abstract

Abstract: Background: Near-total splenectomy (NTS) represents an innovative and effective surgery technique for spleen disease, reducing the risk of severe infections and thromboembolic events after total splenectomy. The authors reported a laparoscopic near-total splenectomy (LNTS) surgical experience following the optimal results of the open approach, describing a standardized and effective minimally invasive technique with the purpose of preserving a minimal residual spleen. Material and methods: From November 2006 to September 2016, 15 patients with splenic and hematologic disease underwent LNTS, according to a laparoscopic procedure developed by the authors. The end criterion was to conserve a remanent spleen of 10–15 cm 3 in size. Results: Patient age ranged between 18 and 59 years. Mean operative time was 70 ± 20 min. Mean hospital stay was 3.46 (range 3–7) days. One complication occurred during the surgery for a lesion of the inferior polar artery with need of a total splenectomy. No conversion to open surgery was necessary. Conclusions: LNTS is a safe and effective technique for the management of splenic and hematologic disease with a low intra- and post-operative complication rate, and it can minimize the late sequelae of secondary splenectomy. However, it requires further studies with more cases to evaluate its role.