Transumbilical single-incision endoscopic splenectomy:Report of ten cases

AIM: To investigate the feasibility and clinical application of transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments.

AIM:To investigate the feasibility and clinical application of transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments.METHODS:Between 2010 and 2012,transumbilical single-incision endoscopic splenectomy was performed in 10 patients in our department,of whom 4 had refractory idiopathic thrombocytopenic purpura,4 had enlarged splenic cyst and 2 had splenic hematoma.A2.5-cm curved incision was made at the lower umbilicus edge,and a 10 mm laparoscope was inserted into the middle of the incision.A 5-mm harmonic scalpel was placed on the right side,and a 5-mm auxiliary instrument on the left side of the laparoscope.Splenic ligaments were incised with a harmonic scalpel,and the splenic pedicle was cut with an Endo-gastrointestinal anastomosis.The spleen was dissected and placed in a large retrieval bag,blended,and then removed.RESULTS:All transumbilical single-incision endoscopic splenectomies were performed successfully with mean operative time of 80±5 min and mean blood loss of150±20 mL.Conversion to laparotomy or multi-port laparoscopic surgery was not required in all cases.All patients were discharged on postoperative days 4-6.During the postoperative hospitalization period,no painkillers were required.No intra-abdominal complications such as infection,ascites,gastric leakage,pancreatic leakage,or wound infection occurred in any case during the 6-mo follow-up.CONCLUSION:Transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments is technically feasible and safe in selected patients.