Laparoendoscopic single site (LESS) splenectomy with a conventional laparoscope and instruments |
| |
Authors: | Colon Modesto J Telem Dana Chan Edward Midulla Peter Divino Celia Chin Edward H |
| |
Affiliation: | Division of General Surgery, Department of Surgery, Mount Sinai School of Medicine, New York, New York, USA. |
| |
Abstract: | Background and Objectives:We present 2 cases of laparoendoscopic single site surgery (LESS) splenectomy performed with a conventional laparoscope and instruments, and the use of a novel internal retraction device.Methods:One patient underwent LESS splenectomy for idiopathic thrombocytopenia purpura (ITP), and a pediatric patient with sickle cell disease underwent LESS splenectomy and cholecystectomy. In each case, a 2-cm vertical incision was made within the confines of the umbilical ring, and a SILS port (Covidien, Norwalk CT) inserted. A 5-mm, 30-degree laparoscope and standard 5-mm instruments were used. After isolation of the splenic hilum, one 5-mm trocar of the SILS port was upsized to 12mm, and a laparoscopic stapler was used to divide the splenic artery and vein. An internal retractor consisting of a laparoscopic bulldog clamp with a hook attachment was used to retract the gallbladder, and to secure the specimen retrieval bag during splenic extraction, which eliminated the need for a fourth trocar.Results:Total operative time was 160 minutes for the LESS splenectomy, and 216 minutes for the LESS splenectomy and cholecystectomy. Both procedures were successfully completed with conventional instrumentation and a SILS port, without the need for additional incisions or trocars. No complications occurred, and both patients had an uneventful recovery.Conclusions:LESS splenectomy is a feasible procedure that can be performed safely. Although articulating instruments and laparoscopes may offer advantages, they are not necessary for performing LESS splenectomy. |
| |
Keywords: | Splenectomy Laparoendoscopic single site surgery (LESS) Single site surgery |
本文献已被 PubMed 等数据库收录! |
|