Page 7 - Journal of WALS

Paul A Kisanga

special port is used in a single small open incision of about splenectomy was done using single incision were found and
2 to 3 cm through umbilicus and all instruments passed through included in the review. Other papers that had relevant literature
it for performing an intra-abdominal operation (Fig. 4). However, to help in the review, such as series of comparative study
the anatomical position of the spleen coupled by the limited between open and conventional laparoscopy, were also
and compromised ergonomics theoretically poses some reviewed. Parameters of particular concern are:
challenges to the operating surgeon as the instruments are Position of the patient, abdominal access technique, intra-
more delicate and manipulation angle small. 1,5 operative complication, time of surgery, weight of the spleen,
This study is aimed at reviewing the experience of SILS in conversion, postoperative pain, duration of hospital stay and
performing splenectomy and its outcome. patient satisfaction.

AIMS AND OBJECTIVES
RESULTS
To review cases of single incision/single port splenectomy
reported in the literature and analyze the outcome and A total of nine articles were found that were specific for single
complications. Specific objectives were to look at the access incision splenectomy, most were case reports and one small
technique, duration of surgery, intraoperative complications, series of eight patients (Table 1). There was one series of
conversion rate, postoperative pain, postoperative hospital stay, 20 patients in a review of experience with single incision
cosmetic outcome and patient/parents acceptability. splenectomy in which six patients had splenectomy. In this
review, total of 26 patients underwent splenectomy. Age of
MATERIALS AND METHODS patients ranged from 7 months to 73 years. There were three
7
16
Literature search was done using Google, HighWire Press, conversions (11.56%), time of surgery ranged from 64 to
Medscape, SAGES website and Hinari. All papers in which 195 minutes (average of 129.5 minutes), 22 patients had access

Fig. 3: One of the ports (SILS) used for single incision Fig. 4: SILS port applied in the abdominal wall
laparoscopic surgery

Table 1: Single incision splenectomy cases
Author Year No. of Age Access Duration Intraoperative Blood Conversion Spleen Hospital
patients range of surgery complication loss weight stay
(mins) (days)
Rottaman S 2004 1 36 Umbilicus NR – NR NO NR –
Mallardi P 2009 1 24 LUQ 130 – NR NO NR –
Barbaros U 2009 2 25 Umbilicus 110,150 – NR NO NR 2.5
(130)
Erica R 2009 2 – Umbilicus 190 Adherent NR 1 NR 2
pancreatic
mass
Dutta S 2010 6 8 Umbilicus 90 – NR NO NR 2.5
Targoma EM 2010 8 26-73 Umbilicus 60-170 – 2 340-590 gm 2.5
(97)
Hansen N 2010 1 5 Umbilicus 84 – Minimal NO NR 2
You YK 2010 3 38 ULQ 125-195 Gastric NR NO NR NR
(151) perforation
Srinkanth G 2011 1 20 Umbilicus 130 – NR NO NR 2
Joshi Manishi 2011 1 7 months Umbilicus – – NR NO NR 4

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