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Single-incision laparoscopic splenectomy.

Gkegkes ID, Mourtarakos S, Iavazzo C - JSLS (2014 Jul-Sep)

Bottom Line: 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.Low rates of complications and no patient deaths were found.The existing evidence on cosmesis is limited.

View Article: PubMed Central - PubMed

Affiliation: First Department of Surgery, General Hospital of Attica "KAT," Athens, Greece.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of selection process for articles included in review.
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Figure 1: Flow diagram of selection process for articles included in review.

Mentions: Our search of PubMed and Scopus retrieved 47 studies and 62 studies, respectively, among which 34 studies (29 case reports and 5 case series) met the inclusion criteria of our systematic review.1–34 Two additional studies were included through hand searching of references.35,36 The adopted search strategy is schematically presented in Figure 1.


Single-incision laparoscopic splenectomy.

Gkegkes ID, Mourtarakos S, Iavazzo C - JSLS (2014 Jul-Sep)

Flow diagram of selection process for articles included in review.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4208906&req=5

Figure 1: Flow diagram of selection process for articles included in review.
Mentions: Our search of PubMed and Scopus retrieved 47 studies and 62 studies, respectively, among which 34 studies (29 case reports and 5 case series) met the inclusion criteria of our systematic review.1–34 Two additional studies were included through hand searching of references.35,36 The adopted search strategy is schematically presented in Figure 1.

Bottom Line: 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.Low rates of complications and no patient deaths were found.The existing evidence on cosmesis is limited.

View Article: PubMed Central - PubMed

Affiliation: First Department of Surgery, General Hospital of Attica "KAT," Athens, Greece.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus