• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

New laparoscopic “antero-lateral”transperitoneal approach for ultra-splenomagaly

BACKGROUND: Laparoscopic splenectomy (LS) has been considered as the standard approach to remove a normal-sized spleen, but sometimes involves various troubles when applied to splenomegaly. To get good view for performing splenectomy for ultra-splenomegaly in Banti syndrome, for example, we developed “antero-lateral approach” with hand-assisted maneuver. We present our new methods in our recent cases to show how this pcocedure is superior in safety and easiness in intraoperative handling. METHODS: In our new approach, semi-lateral decubitus position on the right side is usually placed and as to the position of cannulae, 4 ports are placed on the skin (left side of umbilicus, and the other three are along the subcostal lesion ). For the last 5 years, 10 patients with splenomegaly were treated with operations for splenectomy in our hospital. HALS with transperitoneal “antero-lateral” approach was performed in 4 patients@(group A). Other cases consisted of open splenectomy or conventional LS (group B). The patients’ features, the operative details and the postoperative outcomes in the both groups were compared. RESULTS: In group A, the average hospital stay was 7 days, while 15days in group B. Operation time, intraoperative blood loss did not show any difference. And in the aspects of intraoperative and postoperative complication, there were not any complications in the two groups. In group A, there was one case with the largest spleen that has ever been reported. The patient was a 51-year-old male suffering Banti syndrome. In preoperative volumemetry by CT scan, the weight of spleen was 4500gr with the maximum length of 35cm. The sites of laparoscopic ports and splenic artery were evaluated and marked (on the skin) by ultrasonography before operation. In the operation,@skin incision for 3 ports (all 10 mm), one of which was just left side of umbilicus and the other two were along the subcostal lesion, and one Gel-port (right subcostal lesion) was made. First, the lower pole and the back side of spleen was dissected from retroperitoneum and then splenic artery was clipped just below the marking which was made preoperatively. Next, the lateral side then the upper pole of spleen was detached from the retroperitoneum. Finally, spleen was excised from pancreas tail by endo-GIA 60 x 3 times. The isolated spleen was divided into 5 pieces by surgical scissors and then picked up through the Gel-port. The operative time was 280 minutes with little bleeding. The postoperative course was uneventful. CONCLUSIONS: In the cases of splenomegaly, HALS with transperitoneal “antero-lateral” approach significantly facilitates the surgical procedure and reduces the operational risk, while maintaining the advantages of conventional LS. HALS with transperitoneal ” antero-lateral ” approach is more feasible and more effective than conventional LS or open laparotomy for the removal of ultra-splenomegaly.


Session: Poster

Program Number: P306

View Poster

Post Views: 44

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2008 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc