Page 9 - Journal of WALS

Paul A Kisanga
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of 8% (2 patients). The duration of surgery ranged from 60 to 2. SSAT guideline indications for splenectomy: Society for Surgery
195 minutes which does not differ from what was found in two of Alimentary Tract 2011:P3.
comparison studies by Maurus and Cogliandolo in LS. 4,5,12 3. John E. Evolving Trends in laparoscopic surgery: Knol. July
2008:version 30.
Some of the reasons that contributed to long operating time 4. Maurus Christine F, Schäfer Markus, Müller Markus K, Clavien
included inexperience of the surgeon, need to do combined Pierre-Alain, Weber Markus. Laparoscopic versus open
procedure and iatrogenic gastric injury that was managed splenectomy for nontraumatic diseases. World J Surg
32(11):2444-49.
8,9
endoscopicaly. Exposure is one of the challenges in SILS 5. Somatomoyor RK. Efficasy and safety of laporoscopic
splenectomy, Srinkanth found that using a suture on the splenectomy: A review of 14 cases using lateral approach. Bol
stomach helped to retract the stomach away and improve Asoc Med PR, April 2009;101(2):43-49.
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exposure of the splenic hillum. Short hospital stay is one of 6. Katkhouda N. Laparoscopic splenectomy outcome and efficacy-
103 consecutive patients. Ann Surg Oct 2998;228(4):568-78.
the advantages of laparoscopic procedures over open, in this 7. Eduardo M Targarona, Jose Luis Pallares, Carmen Balague,
review the median stay was 2.5 days which compares well with Carlos Rodríguez Luppi, Franco Marinello, Pilar Hernández,
conventional LS. 4,5,12 There was no good way of reporting pain, Carmen Martínez, Manuel Trias. Single incision approach for
most surgeons reported moderate postoperative pain, Barbaros splenic Diseases: A preliminary report on a series of 8 cases.
and Hansen reported postoperative pain of 2/10. 13,14 Spleen Surg Endosc Sept 2010;24(9):2236-40.
retrieval was done by putting the spleen into an endo bag and 8. Dutta Sanjeev. Early experience with single incision laparoscopic
surgery: Eliminating the scar from abdominal operations. Journal
morcellating with forceps except when the spleen was required of Pediatric Surg 2009;4(9):1741-45.
for histopathology whereby an incision was extended to remove 9. You1 YK, Lee SK, Hong TH, Kim JG. Single-port laparoscopic
it in block. 17,19 This predisposes the port site for possible future splenectomy: The first three cases. Asian Journal of Endoscopic
Surgery Feb 2010;3(1):33-35.
hernia as seen in the study of Erica in a 24 months follow-up of 10 Clavien PA. Proposed classification of complications of surgery
19
patient who underwent SILS surgery. Patient satisfaction with with examples of utilizing cholecystectomy: Surg May
the cosmetic outcome at discharge and in the immediate 199;111(5):518-26.
postoperative period was reported to be very satisfactory 11. Dindo Daniel, Demartines Nicolas, Clavien Pierre-Alain.
by all. Classification of surgical complications: A new proposal with
evaluation in a Cohort of 6336 patients and results of a survey.
Ann Surg Aug 2004;240(2):205-11.
CONCLUSION 12. Cogliandolo A. Results of laparoscopic and open splenectomy
for nontraumatic diseases. Surg Laprosc Percutan Tech Aug
Single incision laparoscopic splenectomy is gaining popularity, 2001;11(2):256-61.
the review indicates it is a feasible procedure that can safely be 13. Barbaros Umut, Dinçça™ Ahmet. Single incision laparoscopic
done in patients of all ages with low morbidity and clear superior splenectomy: The first two cases. J Gastrointestinal Surgery
cosmetic outcome, at least in the immediate postoperative period. Aug 2009;13(8):1520-32.
Additional exposure of the hillum of the spleen can be obtained 14. Hansen EN, Muensterer OJ. Single incision laparoscopic
splenectomy in a 5-year-old with hereditary spherocytosis. JSLS
by use of percutaneous suture to hold the stomach. The April-Jun 2010;14(2):286-88.
operating time is expected to continue to drop as surgeons get 15. Srikanth G, Wasim MD, Sajjad A, Shetty Neel. Single-incision
more confidence and used to the new and delicate instruments laparoscopic splenectomy with innovative gastric traction suture.
meant to compensate for the compromised ergonomics. The J Minimal Access Surg Jan-March 2011;7(1):68-70.
standard way of reporting on laparoscopic complication is 16. Joshi Manish, Kurhade Shrikant, Peethambaram MS, Kalghatgi
Suhas, Narsimhan Mohan, Ardhanari Ramesh. Single-incision
lacking, the advantages of single incision splenectomy over LS laparoscopic splenectomy solid organ surgery 2011;7(1):65-67.
need a well-balanced prospective cohort study with long term 17. Rottman Steven J, Podolsky Erica R, Kim Eugene, MS3. Joseph
follow-up, before firm conclusions can be drawn. Kern, Curcillo Paul G II. Single port access (SPA) splenectomy.
Am J Surg May 2004;187(5):618-20.
REFERENCES 18. Malladi Preeti1, Hungness Eric, Nagle Alex. Single access
laparoscopic splenectomy. JSLS Oct-Dec 2009;13(4):601-04.
1. RK Mishra. Textbook of practical laparoscopic surgery 19. Podolosky Erica R, Curcillo Paul G II. Single port access (SPA)
(2nd ed). Jaypee Brothers Medical Publishers, New Delhi, India, surgery: A 24 months experience. J Gastrointest Surg 2010;14:
2009. 759-67.

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