title: Grasper-assisted versus traditional laparoscopic splenectomy in the management of hematologic disorders.
abstract: OBJECTIVE
  To compare the technical benefits of grasper-assisted laparoscopic splenectomy (LS) with traditional LS.
  
  
  METHODS
  The study comprised 27 consecutive patients who were admitted to our hospital from 1998 to 2002 and underwent LS: 13 patients underwent traditional LS (group 1), and 14 had grasper-assisted LS (group 2).
  
  
  RESULTS
  In both groups, the most common indication for LS was idiopathic thrombocytopenic purpura. There was no difference between the groups in the demographic characteristics of patients. All splenectomies were performed in the right semidecubitus position, using four or five trocars. Conversion to open surgery was required in one patient (7.7%) in group 1 and in one patient (7.1%) in group 2. Both conversions occurred during the initial 16 operations and no conversion occurred during the subsequent 11 operations. The mean operating time was significantly shorter for group 2 (132 minutes) than for group 1 (154 minutes) (P <.005). Mean estimated blood loss (201 vs. 282 mL) was also lower in group 2 than in group 1 (P <.05). The mean length of hospital stay was 3.3 days in group 1 and 2.4 days in group 2 (P >.05).
  
  
  CONCLUSIONS
  Grasper-assisted LS is both safe and feasible in patients with hematologic diseases. This technique can be preferred in order to grasp and position the spleen during the surgery.
authors.affiliation: Department of General Surgery, University of Erciyes, Kayseri, Turkey. bedirlia@yahoo.com
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Bedirli
authors.forename: Erdogan M
authors.initials: EM
authors.lastname: Sozuer
authors.forename: Abdullah
authors.initials: A
authors.lastname: Saglam
authors.forename: Omer
authors.initials: O
authors.lastname: Sakrak
authors.forename: Ilkay
authors.initials: I
authors.lastname: Guler
authors.forename: Can
authors.initials: C
authors.lastname: Kucuk
authors.forename: Yucel
authors.initials: Y
authors.lastname: Aritas
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D013156:Splenectomy / Q000295:instrumentation* / Q000379:methods*