Transumbilical Single-Incision Laparoscopic Splenectomy Using Conventional Instruments: A Single Surgeon’s Experience

Fan Ying. Department of the First Minimal Invasive Surgery and Bile Duct Surgery, Sheng Jing Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of China

Background Laparoendoscopic single-site surgery is partly responsible for the explosion of minimally invasive procedures . Herein, we share our six cases to demonstrate the feasibility of scarless transumbilical single-incision laparoscopic splenectomy using conventional instruments in the management of different kinds of splenic diseases.
Methods A total of six patients who underwent transumbilical single-incision laparoscopic splenectomy between January 2010 to August 2010 at our institution were recruited; data were collected prospectively. The characteristics and outcomes of patients were analyzed. Results All the six operations were successful without converting to open surgery with operative duration 180~360min,estimated blood loss 100~400ml and hospital stay 7~9days. All the patients were free of postoperative bleeding,pancreatic leakage,venous thrombosis and fever complications. One case of postoperative abdominal effusion occurred and an interventional centesis drainge was applied with ideal result . There were no wound infections in the cohort. Patients were uniformly pleased with the cosmetic results of the operation.
Conclusions Transumbilical single-incision laparoscopic splenectomy appears to be a technically feasible alternative to standard endoscopic procedure and can be performed using conventional instruments by experienced hands. But improved cosmesis must be carefully weighed against the potentially increased difficulties and risks of the procedure.
Keywords splenectomy; laparoscopy; single-incison