Single-port laparoscopic splenectomy with finger fracture extraction, a novel technique in Egypt (the initial experience in Kasr Al Ainy Hospital)

Elmonim, Ahmed Maher Abd; Fahmy, Mohammed H.; Elshal, Mohamed Fathy

doi:10.4103/ejs.ejs_385_21

Single-port laparoscopic splenectomy with finger fracture extraction, a novel technique in Egypt (the initial experience in Kasr Al Ainy Hospital)

Authors

Abstract

Background
Laparoscopic splenectomy can be practiced safely in the recent few years with standardized steps. One of its main disadvantages is the remaining scar of specimen retrieval wound. Applying single-incision laparoscopic surgery principles with the described finger fracture technique for specimen extraction can add the advantage of scarless procedure in hand with maintaining splenic tissue integrity for histopathological examination. The aim is to evaluate the new technique single-port laparoscopic splenectomy with finger fracture extraction of the removed spleen.
Patients and methods
This case series study was conducted on 13 patients with different spleen pathological conditions. They underwent single-port laparoscopic splenectomy using “GelPoint®” system then removing it through the used port after fracturing it by surgeon’s fingers.
Results
Thirteen patients underwent Single port laparoscopic splenectomy (SPLS-SP), the mean operation time ranged between 120 and 180 min. All cases completed laparoscopy without conversion to open procedure; of them, two cases required additional port insertion for assistance and a retrieval Pfannenstiel incision for the large sized spleen. No blood transfusion was required perioperatively with no morbidities or mortalities. Average hospital stay was around 4 days with average narcotic requirements in the postoperative period.
Conclusion
Single-port laparoscopic splenectomy can be done safely through a small, single umbilical incision using “GelPoint®” system. The specimen can be retrieved through the same incision after fracturing it into small pieces by the surgeon’s fingers thus preserving the splenic tissues integrity for histopathological examination.

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