Single incision versus reduced port splenectomy - Searching for the best alternative to conventional laparoscopic splenectomy

Julio Lopez Monclova, Eduardo M. Targarona, Pablo Vidal, Yerald Peraza, Francisco Garcia, Carlos Rodriguez Otero, Luis Pallares, Carmen Balague, Manuel Trias

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20 Citations (Scopus)

Abstract

Background: Laparoscopic splenectomy (LS) is a well accepted approach for the treatment of multiple hematologic diseases. Single port access splenectomy (SPAS) emphasizes the concept of surgery through one small incision. The reduced port access splenectomy (RPAS) entails the use of fewer trocars of smaller sizes. The aim of this study was to compare the clinical outcomes after LS, SPAS, and RPAS, and to analyze the aesthetic result and patient satisfaction. Methods: We included patients who underwent LS (group 1, n = 15), SPAS (group 2, n = 8), and RPAS (group 3, n = 10) between June 2008 and February 2012, whose final spleen weight was less of 500 g. The outcome parameters analyzed were operative time, need of additional trocars, blood loss, blood transfusion, weight of the spleen, postoperative complications, and duration of hospital stay. To evaluate the cosmetic result, patients were asked to take the Body Image Questionnaire. Results: Patients in group 3 were younger than group 1. Operative time was significantly longer in group 2 compared to groups 1 and 3 (83 ± 19 vs. 131 ± 43 vs. 81 ± 22 min, p = 0.01). There was no need to convert to open surgery in any group, nor were there differences in intra- or postoperative outcome. There were no differences between the groups in relation to the analgesic requirements. Twenty-two out of the 33 patients answered the questionnaire. There was a significant advantage in group 2 and 3 in the body image index with respect to group 1. There were no differences between groups 2 and 3 (7.3 ± 2.8 vs. 5.8 ± 1.3 vs. 5.1 ± 0.4, p < 0.02). Conclusions: RPAS is a good alternative to LS and SPAS. It improves the aesthetic results as compared to LS, whereas minimizes the technical challenges faced with SPAS. © 2012 Springer Science+Business Media, LLC.
Original languageEnglish
Pages (from-to)895-902
JournalSurgical Endoscopy
Volume27
Issue number3
DOIs
Publication statusPublished - 1 Jan 2013

Keywords

  • Analgesic requirements
  • Body image
  • Cosmesis assessment
  • Laparoscopic splenectomy
  • Reduced port surgery
  • Single port splenectomy

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