Prospective randomized comparison of clinical results between hand-assisted laparoscopic and open splenectomies

Abstract

For splenomegaly, HALS significantly facilitates the surgical procedure and reduces the hospital stay while maintaining the advantages of OS such as tactile sense as well as easy and atraumatic manipulation of enlarged spleens.

Laparoscopic Splenectomy for Benign Hematological Disorders in Adults: A Systematic Review

“…Ιf LS is chosen, it can be performed using the same surgical technique, providing that the ports are placed more caudally on the abdominal wall, directly related to the lower pole of the spleen (30). For these patients, hand-assisted LS has been proposed (11,20,31,32) as an effective, safe and feasible alternative. Analyzing the feasibility of LS in cases of massive splenomegaly (spleen weight >2000 g) in patients with benign hematological disorder, Al-Mulhim (7) concluded that although LS was feasible in 90% of patients, the condition was significantly associated with prolonged operative time, more blood loss, increased postoperative morbidity, longer time to liquid diet and prolonged postoperative hospital stay.…”

Minimally invasive splenectomy: an update and review

“…In 1 RCT comparing HALS to OS, median splenic weight for the HALS group was 1200 g, with no conversions. 26 Moreover, spleens weighing consider ably more than 3000 g have been safely removed using HALS. 7,17,19,20,26 …”

“…Once the spleen is within the bag, it is morcelated as necessary and pulled out through the port site. 7,11,25,26,30 Hand-assisted laparoscopic splenectomy has been shown to facilitate the surgical management of massive splenomegaly, allowing a traumatic manipulation of enlarged spleens. In 1 RCT comparing HALS to OS, median splenic weight for the HALS group was 1200 g, with no conversions.…”

“…Compared with LS, HALS has been associated with fewer conversions to OS and may have fewer postoperative complications. 7,11,20,26 Robotic splenectomy For robotic splenectomy, the patient is positioned in the right lateral decubitus position with a reverse Trendelenburg inclination. Laparoscopic port sites are similar to those described previously.…”

Mini-invasive tension-free surgery for female urinary incontinence

“…A better comprehension of the pathophysiology of this disease, has allowed the introduction of modern techniques for its treatment, including the recent minimally invasive techniques using tension-free tape. With the advent of laparoscopic surgery, which has been successfully performed with great advantages compared to the traditional techniques (5)(6)(7)(8), incontinence surgical repair has been also performed with this mini-invasive approach.…”