title: Hand-assisted laparoscopic splenectomy--preliminary experience in southern Taiwan.
abstract: BACKGROUND
  A hand-assisted laparoscopic procedure allows the surgeon to insert the nondominant hand into the abdomen, and helps to recover the tactile sensation. For a massively enlarged spleen, this technique overcomes difficulty in conventional laparoscopic splenectomy. The advantages of minimally-invasive surgery can still be preserved. We describe our preliminary experience in hand-assisted laparoscopic splenectomy.
  
  
  METHODS
  The data of 5 patients who presented with splenomegaly and underwent hand-assisted laparoscopic splenectomy between April 2000 and January 2004 were reviewed retrospectively for analysis.
  
  
  RESULTS
  The mean age was 45.4 +/- 6.6 years, and the hospital stay was 6.6 +/- 1.0 days. The splenic length and weight averaged 20.6 +/- 5.9 cm and 1084.2 +/- 647.8 g. The operative time and blood loss averaged 218.2 +/- 40.2 minutes and 220 +/- 166.1 ml. There was no conversion to open splenectomy. No mortality or morbidity was noted in our series.
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic splenectomy is a safe and feasible procedure, even in our initial experience. It helps in exploration of the surgical field and handling of a fragile spleen, especially in patients with massively enlarged spleens. Although another incision is necessary, the advantages of laparoscopic surgery are still retained.
authors.affiliation: Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Lee
authors.forename: Shih-Chung
authors.initials: SC
authors.lastname: Wu
authors.forename: Chee-Chien
authors.initials: CC
authors.lastname: Yong
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly / Q000601:surgery*