Transumbilical Single-Incision Laparoscopic Splenectomy Plus Pericardial Devascularization Using Conventional Instruments: Initial Experience of 5 Cases

Abstract

Abstract

Purpose:

Laparoendoscopic single-site surgery (LESS) has been proposed for several intra-abdominal surgical interventions. However, application of the LESS technique in portal hypertension is still in its infancy. We report in this article a new technique of LESS splenectomy plus pericardial devascularization with conventional laparoscopic instruments in patients with portal hypertension.

Patients and Methods:

From January 2010 to April 2012, LESS splenectomy plus pericardial devascularization was performed on 5 patients with portal hypertension. Surgical techniques and short-term outcomes were summarized and analyzed retrospectively.

Results:

All the operations were successful with a mean operative duration of 252 minutes (range, 220–270 minutes), intraoperative blood loss of 290 mL (range, 250–350 mL), and hospital stay of 8.2 days (range, 7–9 days). No intraoperative or postoperative complications were recorded. The umbilical incision healed well with a satisfactory cosmetic effect.

Conclusions:

LESS splenectomy plus pericardial devascularization is feasible when performed by experienced laparoscopic surgeons and may offer safety comparable to that of the conventional laparoscopic operation.