Hand-assisted laparoscopic surgery with a Pfannenstiel incision in beta-thalassemia patients: initial experience.
BACKGROUND
beta-Thalassemia patients have splenomegaly significant enough to require splenectomy; furthermore, these patients also often require concurrent procedures.


METHODS
Between January and October 2005, seven patients with beta-thalassemia underwent hand-assisted laparoscopic splenectomy with cholecystectomy, appendectomy, and liver biopsy with the hand-port device introduced through a Pfannenstiel incision.


RESULTS
The median age of the patients was 28 years, and the median spleen length was 23 cm. The median operating time was 210 minutes; there were no conversions to an open procedure; and the median spleen weight was 1072 g. One major postoperative complication occurred. The median hospital stay was 6 days.


CONCLUSIONS
The proposed hand-assisted laparoscopic approach is safe and feasible. It provides a minimally invasive alternative that may become the treatment of choice in beta-thalassemia patients who require concurrent operations.
Leandros
Emmanuel
E
First Department of Propedeutic Surgery, University of Athens, Hippokration Hospital, 114 V Sofias Avenue, Athens, 11527, Greece.
Alexakis
Nicholas
N
Albanopoulos
Konstadinos
K
Dardamanis
Dimitris
D
Karagiorga
Markisia
M
Gomatos
Ilias
I
Papadopoulos
Stefanos
S
Bacoyiannis
Christos
C
Bramis
John
J
D000293:Adolescent; D000328:Adult; D001062:Appendectomy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000150:complications*