The lateral approach to laparoscopic splenectomy

Adrian Park, Michel Gagner, Alfons Pomp

Research output: Contribution to journalArticlepeer-review

108 Scopus citations

Abstract

BACKGROUND: Laparoscopic splenectomy has been shown to result in shorter hospital stays and a quicker return to work than conventional splenectomy. Having tried the anterior 5 trocar approach, we developed a 4 trocar lateral approach and now present our experience with 22 cases. METHODS: All patients were placed in the right lateral decubitus position. A 10-mm trocar was inserted in the left subcostal region, 2 in the flank, and a 5-mm trocar dorsally. A 30°laparoscope was used. Splenectomy was performed for varying pathologies. RESULTS: Operating room (OR) time averaged 169 minutes, spleen weight 513 grams, and postoperative (post-op) stays 5.4 days (median 3 days). One patient was converted to laparotomy. There were no deaths, post-op abscesses, pancreatic injuries, or bleeding complications. CONCLUSIONS: The lateral approach affords superior exposure, allowing easier dissection of splenic hilar structures. Over varying patient habitus and spleen size it has been demonstrated to be the approach of choice for laparoscopic splenectomy.

Original languageEnglish (US)
Pages (from-to)126-130
Number of pages5
JournalAmerican journal of surgery
Volume173
Issue number2
DOIs
StatePublished - Feb 1997
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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