Misiakos EP, Bagias G, Liakakos T, Machairas A. Laparoscopic splenectomy: Current concepts. World J Gastrointest Endosc 2017; 9(9): 428-437 [PMID: 28979707 DOI: 10.4253/wjge.v9.i9.428]
Corresponding Author of This Article
Evangelos P Misiakos, MD, FACS, Associate Professor of Surgery, 3rd Department of Surgery, Attikon University Hospital, University of Athens School of Medicine, 76 Aigeou Pelagous Street, Agia Paraskevi, 15 341, Attica, 12462 Athens, Greece. misiakos@med.uoa.gr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Sep 16, 2017; 9(9): 428-437 Published online Sep 16, 2017. doi: 10.4253/wjge.v9.i9.428
Laparoscopic splenectomy: Current concepts
Evangelos P Misiakos, George Bagias, Theodore Liakakos, Anastasios Machairas
Evangelos P Misiakos, Anastasios Machairas, 3rd Department of Surgery, Attikon University Hospital, University of Athens School of Medicine, Attica, 12462 Athens, Greece
George Bagias, Clinic for General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, Germany
Theodore Liakakos, 1st Department of Surgery, National and Kapodistrian University of Athens, Medical School, Laikon General Hospital, 11527 Athens, Greece
Author contributions: Misiakos EP contributed to study concept and design, literature review, interpretation of data; Bagias G contributed to literature review and writing of the paper; Liakakos T contributed to study supervision, mentorship, surgery part of the manuscript; Machairas A contributed to study guidance and supervision, editing the manuscript.
Conflict-of-interest statement: The authors declare they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Evangelos P Misiakos, MD, FACS, Associate Professor of Surgery, 3rd Department of Surgery, Attikon University Hospital, University of Athens School of Medicine, 76 Aigeou Pelagous Street, Agia Paraskevi, 15 341, Attica, 12462 Athens, Greece. misiakos@med.uoa.gr
Telephone: +30-210-5326419
Received: February 10, 2017 Peer-review started: February 10, 2017 First decision: May 10, 2017 Revised: May 21, 2017 Accepted: July 21, 2017 Article in press: July 24, 2017 Published online: September 16, 2017 Processing time: 212 Days and 19.4 Hours
Abstract
Since early 1990’s, when it was inaugurally introduced, laparoscopic splenectomy has been performed with excellent results in terms of intraoperative and postoperative complications. Nowadays laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen. However some contraindications still apply. The evolution of the technology has allowed though, cases which were considered to be absolute contraindications for performing a minimal invasive procedure to be treated with modified laparoscopic approaches. Moreover, the introduction of advanced laparoscopic tools for ligation resulted in less intraoperative complications. Today, laparoscopic splenectomy is considered safe, with better outcomes in comparison to open splenectomy, and the increased experience of surgeons allows operative times comparable to those of an open splenectomy. In this review we discuss the indications and the contraindications of laparoscopic splenectomy. Moreover we analyze the standard and modified surgical approaches, and we evaluate the short-term and long-term outcomes.
Core tip: With the advent of laparoscopic techniques, laparoscopic splenectomy has become the procedure of choice for benign and malignant diseases of the spleen. Splenomegaly can be alternatively treated with modified hand-assisted approach. In addition the introduction of advanced laparoscopic tools for ligation and electrocauterization contributed to reduced blood loss at surgery and minimal morbidity.
