Outpatient laparoscopic splenectomy: patient safety and satisfaction

Edwin, Bjørn; Skattum, X.; Ræder, Johan; Trondsen, Erik; Buanes, Trond

doi:10.1007/s00464-003-9174-x

Cited by 15 publications

(4 citation statements)

References 24 publications

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“…In the study carried by Romano et al (2002)16 the average operating time was 420 min (range, 90-165 min) while in another study carried by Edwin et al (2007), the median operative time was 58 min (range: 45-135min). 17 The average postoperative hospital stay was 4 days (range, 3-5) which was similar to that in the study of Romano et al (2006) who reported 4.2 days (range, 3-7). 16 We had no peri-operative mortality neither it was reported in the follow up period.…”

Section: Table (2): Resultssupporting

confidence: 87%

Stapleless laparoscopic splenectomy in haematological disorders using LigaSure

El-Anwar

Fouad

Nasser

et al. 2008

Ain Shams Journal of Surgery

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Both technical and technological advances over the past few years have made laparoscopic splenectomy (LS) more feasible and acceptable. Intraoperative bleeding is the main complication and cause of conversion during LS. Different hemostatic techniques are used for vascular control. In this study, we evaluate LigaSure vessel sealing system as the sole instrument in addition to the lateral approach for achieving a safe vascular control.Eleven patients with hematological disorders of the spleen were enrolled in this 2 year study for LS at Ain Shams University Hospitals. Eight patients had idiopathic thrombocytopenic purpura (ITP), two patients with hereditary spherocytosis and one patient with Evan's syndrome.In all patients the LigaSure vessel sealing system with lateral approach was used to achieve safe vascular control. The patients were 6 females and 5 males, their age ranging between 17-23 years (Median= 20 yrs). The intraoperative blood loss, need for blood transfusion, operative time, post-operative complications and hospital stay as well as the cost were evaluated.Nine cases were successfully performed laparoscopically with two conversions due to hilar bleeding. In all but two patients (converted patients) the intra-operative blood loss was less than 100ml (range 50-100ml) with no need for blood transfusion.The operative time range was 70-100 minutes (median 85 minutes). There were no mortalities in our series. The average hospital stay was 4 days (range 3-5 days), and apart from minor wound infection, no post operative complications were recorded.Stapleless LS using LigaSure vessel sealing system with the lateral approach is a safe procedure to carry out laparoscopic splenectomy.

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Section: Table (2): Resultssupporting

confidence: 87%

Stapleless laparoscopic splenectomy in haematological disorders using LigaSure

El-Anwar

Fouad

Nasser

et al. 2008

Ain Shams Journal of Surgery

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“…This study collects the experience of four Scandinavian hospitals. All these institutions have used identical surgical technique and clinical strategy which was introduced and lead by one of the authors (BE) [8,9].…”

Section: Introductionmentioning

confidence: 99%

Should we use laparoscopic adrenalectomy for metastases? Scandinavian multicenter study

Marangos

Kazaryan

Rosseland

et al. 2009

Journal of Surgical Oncology

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“…2,4,11,12 The hospital stay is also shorter 7,13 with mean hospital stay reported of 2.4-5 days 5,6,8,10,12,14,15 and even one small series reported successful day-case laparoscopic splenectomy. 15 There is not an increased risk of missing accessory spleens, 16 and the conversion rate to open operation is reported at 0-15% in recent series. [2][3][4][5][6]9,10,14,15,18,19 Little data are present in the literature examining the role of laparoscopic splenectomy in the case of splenomegaly, and there has been concern regarding higher conversion rates and morbidity.…”

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confidence: 99%

Laparoscopic splenectomy: a personal series of 140 consecutive cases

Pattenden

Mann

Metcalfe

et al. 2010

annals

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Ann R Coll Surg Engl 2010; 92: 398-402 398Since the first laparoscopic splenectomy in 1991, 1 the procedure has been rapidly established as a safe and effective treatment for a range of benign and malignant haematological conditions. The procedure has tended to take longer than open splenectomy with median operating times in recently reported series of 85-231 min; 2-6 however, it is associated with low morbidity rates of 18-26% 2,5,7 and zero mortality in some series 5,7-10 with others recently reporting mortality of up to 4%. 2,4,11,12 The hospital stay is also shorter 7,13 with mean hospital stay reported of 2.4-5 days 5,6,8,10,12,14,15 and even one small series reported successful day-case laparoscopic splenectomy. 15 There is not an increased risk of missing accessory spleens, 16 and the conversion rate to open operation is reported at 0-15% in recent series. [2][3][4][5][6]9,10,14,15,18,19 Little data are present in the literature examining the role of laparoscopic splenectomy in the case of splenomegaly, and there has been concern regarding higher conversion rates and morbidity. 20 Several reports suggest advantages of hand-assisted techniques with laparoscopic splenectomy for massive spleens. 4,15,21 However, recently, a small series did not require hand assistance or conversion to open operation in the latter part of their experience. 12Other centres have advocated open splenectomy for spleens larger than 1 kg. 22The aim of this study was to evaluate the results of a large, single-centre experience of laparoscopic splenectomy, focusing on morbidity, hospital stay, and conversion to open operation. In particular, the role of laparoscopic splenectomy in cases of splenomegaly over 1 kg was examined. RESULTS In total 140 laparoscopic splenectomies were performed with a complication rate of 15% and no mortality. The median operative time was 100 min and conversion to open procedure was necessary in 2.1%. Conversion for cases of splenomegaly was only 5.7%. The median hospital stay was 3 days. CONCLUSIONS Laparoscopic splenectomy is a safe procedure with acceptable morbidity. A laparoscopic approach for splenomegaly is feasible. Patients and Methods Study design

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Outpatient laparoscopic splenectomy: patient safety and satisfaction

Abstract: Laparoscopic splenectomy can be completed in a relatively short time; therefore, it is feasible, safe, and satisfactory for most patients as an outpatient procedure.

Cited by 15 publications

References 24 publications

Stapleless laparoscopic splenectomy in haematological disorders using LigaSure

Stapleless laparoscopic splenectomy in haematological disorders using LigaSure

Should we use laparoscopic adrenalectomy for metastases? Scandinavian multicenter study

Laparoscopic splenectomy: a personal series of 140 consecutive cases

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