TY - JOUR
T1 - Laparoendoscopic single site (LESS) splenectomy with a conventional laparoscope and instruments
AU - Colon, Modesto J.
AU - Telem, Dana
AU - Chan, Edward
AU - Midulla, Peter
AU - Divino, Celia
AU - Chin, Edward H.
PY - 2011/7
Y1 - 2011/7
N2 - Background and Objectives: We present 2 cases oflaparoendoscopic single site surgery (LESS) splenectomyperformed with a conventional laparoscope and instruments,and the use of a novel internal retraction device.Methods: One patient underwent LESS splenectomy foridiopathic thrombocytopenia purpura (ITP), and a pediatricpatient with sickle cell disease underwent LESS splenectomyand cholecystectomy. In each case, a 2-cm verticalincision was made within the confines of theumbilical ring, and a SILS port (Covidien, Norwalk CT)inserted. A 5-mm, 30-degree laparoscope and standard5-mm instruments were used. After isolation of the splenichilum, one 5-mm trocar of the SILS port was upsized to12mm, and a laparoscopic stapler was used to divide thesplenic artery and vein. An internal retractor consisting ofa laparoscopic bulldog clamp with a hook attachment wasused to retract the gallbladder, and to secure the specimenretrieval bag during splenic extraction, which eliminatedthe need for a fourth trocar.Results: Total operative time was 160 minutes for theLESS splenectomy, and 216 minutes for the LESS splenectomyand cholecystectomy. Both procedures were successfullycompleted with conventional instrumentationand a SILS port, without the need for additional incisionsor trocars. No complications occurred, and both patientshad an uneventful recovery.Conclusions: LESS splenectomy is a feasible procedurethat can be performed safely. Although articulating instrumentsand laparoscopes may offer advantages, they arenot necessary for performing LESS splenectomy.
AB - Background and Objectives: We present 2 cases oflaparoendoscopic single site surgery (LESS) splenectomyperformed with a conventional laparoscope and instruments,and the use of a novel internal retraction device.Methods: One patient underwent LESS splenectomy foridiopathic thrombocytopenia purpura (ITP), and a pediatricpatient with sickle cell disease underwent LESS splenectomyand cholecystectomy. In each case, a 2-cm verticalincision was made within the confines of theumbilical ring, and a SILS port (Covidien, Norwalk CT)inserted. A 5-mm, 30-degree laparoscope and standard5-mm instruments were used. After isolation of the splenichilum, one 5-mm trocar of the SILS port was upsized to12mm, and a laparoscopic stapler was used to divide thesplenic artery and vein. An internal retractor consisting ofa laparoscopic bulldog clamp with a hook attachment wasused to retract the gallbladder, and to secure the specimenretrieval bag during splenic extraction, which eliminatedthe need for a fourth trocar.Results: Total operative time was 160 minutes for theLESS splenectomy, and 216 minutes for the LESS splenectomyand cholecystectomy. Both procedures were successfullycompleted with conventional instrumentationand a SILS port, without the need for additional incisionsor trocars. No complications occurred, and both patientshad an uneventful recovery.Conclusions: LESS splenectomy is a feasible procedurethat can be performed safely. Although articulating instrumentsand laparoscopes may offer advantages, they arenot necessary for performing LESS splenectomy.
KW - Laparoendoscopic single site surgery (LESS)
KW - Single site surgery
KW - Splenectomy
UR - http://www.scopus.com/inward/record.url?scp=80053632133&partnerID=8YFLogxK
U2 - 10.4293/108680811X13125733356918
DO - 10.4293/108680811X13125733356918
M3 - Article
C2 - 21985729
AN - SCOPUS:80053632133
SN - 1086-8089
VL - 15
SP - 384
EP - 386
JO - Journal of the Society of Laparoendoscopic Surgeons
JF - Journal of the Society of Laparoendoscopic Surgeons
IS - 3
ER -