title: Hand-assisted laparoscopic splenectomy in the setting of splenomegaly.
abstract: BACKGROUND
  Hand-assisted laparoscopic surgery (HALS) devices may be well suited to splenectomy in cases of splenomegaly.
  
  
  METHODS
  All cases of HALS for splenectomy between 1997 and 2001 were reviewed. Patient characteristics, operative details, and morbidity and mortality were analyzed.
  
  
  RESULTS
  HALS for splenectomy was performed in 54 patients. A total of 39 patients with massive splenomegaly (MS) (>600 g) were identified. The average weight of the MS group was 1285 +/- 505 g. There was one (3%) conversion. Operative time was 159 +/- 65 min, estimated blood loss was 257 +/- 240 ml, and length of hospital stay was 5.4 +/- 2.9 days. Morbidity was limited to 13 patients (24%), and there were two postoperative mortalities (5.1%).
  
  
  CONCLUSIONS
  HALS for splenectomy in the setting of splenomegaly is feasible and safe. For the surgeon considering a laparoscopic approach in the setting of splenomegaly, a hand-assisted technique is ideally suited for removal of the enlarged spleen.
authors.affiliation: Department of Surgery, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01655, USA. kabang@ummhc.org
authors.forename: G K
authors.initials: GK
authors.lastname: Kaban
authors.forename: D R
authors.initials: DR
authors.lastname: Czerniach
authors.forename: R
authors.initials: R
authors.lastname: Cohen
authors.forename: Y W
authors.initials: YW
authors.lastname: Novitsky
authors.forename: S M
authors.initials: SM
authors.lastname: Yood
authors.forename: R A
authors.initials: RA
authors.lastname: Perugini
authors.forename: J J
authors.initials: JJ
authors.lastname: Kelly
authors.forename: D E M
authors.initials: DE
authors.lastname: Litwin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000150:complications / Q000601:surgery*; D013163:Splenomegaly / Q000209:etiology / Q000601:surgery*