Single-access transumbilical laparoscopic splenectomy using curved reusable instruments

Dapri, Giovanni; Bron, Dominique; Himpens, Jacques; Casali, Lorenzo; Carnevali, Pietro; Koustas, Pavlos; Cadière, Guy-Bernard

doi:10.1007/s00464-011-1678-1

Cited by 10 publications

(3 citation statements)

References 13 publications

(29 reference statements)

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“…The effects of instrument crowding, as well as the absence of triangulation, are among the most common technical issues. 11 , 27 Consequently, the variety of movements is limited because of the proximity of the instruments. This issue can be resolved by various means.…”

Section: Discussionmentioning

confidence: 99%

Single-Incision Laparoscopic Splenectomy

Gkegkes

Mourtarakos

Iavazzo

2014

JSLS

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Background and Objectives:The single-incision approach in laparoscopic surgery is a relatively new concept. This systematic review of the literature was performed to appraise the existing clinical evidence concerning the use of the single-incision technique for spleen resection.Methods:We performed a systematic search of the PubMed and Scopus databases, and the studies retrieved were included in our review. The references of the included studies were also hand searched.Results:Thirty-one relevant studies were found in the field including 81 patients with an age range from 0.6 to 90 years and a body mass index range from 18 to 36.7 kg/m2. Splenomegaly (44.6%), idiopathic thrombocytopenic purpura (31%), and immune thrombocytopenic purpura (6.8%) were the most common indications for the procedure. Concerning the applied port system, multiple single ports (5 to 12 mm) were used in 54.4% of patients, the SILS port (Covidien, Mansfield, Massachusetts) was used in 26.6%, the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) was used in 7.6%, glove ports were used in 6.3%, and the GelPort (Applied Medical, Rancho Santa Margarita, California) was used in 5.1%. The median operative time was 125 minutes (range, 45–420 minutes), and the median quantity of blood loss was 50 mL (range, 10–450 mL). No conversion to open surgery and no transfusion were needed. The length of hospital stay was between 1 and 9 days. Low rates of complications and no patient deaths were found. The existing evidence on cosmesis is limited.Conclusion:Single-site/single-port laparoscopic surgery is a minimally invasive procedure that seems to be a challenging alternative in the management of spleen resection.

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Section: Discussionmentioning

confidence: 99%

Single-Incision Laparoscopic Splenectomy

Gkegkes

Mourtarakos

Iavazzo

2014

JSLS

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“…In the setting of SI fundoplication, both the standard[14,21,22,27,28,30] and the articulating setup[11,12,18,27,32] has been applied. Dapri et al[23,54], proposed the use of specialized reusable pre bent instruments that enabled intracorporeal and extracorporeal triangulation, thus avoiding conflict between the instruments and the scope.…”

Section: Discussionmentioning

confidence: 99%

Single incision laparoscopic fundoplication: A systematic review of the literature

Perivoliotis

Sarakatsianou

Tepetes

et al. 2019

WJGS

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BACKGROUND Fundoplication, was first introduced as a surgical treatment method of gastroesophageal reflux disease. Consequently, several modifications of this method have been described, whereas laparoscopic fundoplication was recently introduced. Although single incision (SI) fundoplication was considered as an alternative to the conventional laparoscopic approach, several studies reported an increased operation duration, and high rates of multiport conversion and incisional hernia. AIM To provide a current overview of the technical variations and the postoperative outcomes of patients submitted to SI fundoplication. METHODS The present systematic review of the literature was designed and conducted on the basis of the PRISMA guidelines. A systematic screening of the electronic scholar databases (Medline, Scopus and Web of Science) was performed. RESULTS Literature search resulted in the identification of 19 studies. Overall, 266, 137 and 110 SI Nissen, Dor and Toupet fundoplications were reported, respectively. In the majority of the trials, standard laparoscopic instruments were used. The left liver lobe was displayed through the use of forceps, graspers, retractors, drains or even glue. Both intra-corporeal and extracorporeal suturing was described. Mean operative time was 136.3 min. Overall complication rate was 5.2% and the rate of incisional hernia was 0.9%. No mortality was reported. CONCLUSION Due to the methodological heterogeneity and the lack of high quality studies comparing multi to single access techniques and the several variations, we conclude that further well designed studies are necessary, in order to evaluate the role of SI fundoplication.

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“…Likewise, some reports on single-access laparoscopic splenectomy (SALS) have been published in the literature (13)(14)(15)(16)(17). These studies, although limited by sample size, indicate to date that the spleen can be safely removed using SAL and all the authors have endorsed the feasibility of this approach.…”

Section: Discussionmentioning

confidence: 99%