title: Laparoscopic splenectomy: consensus and debatable points.
abstract: BACKGROUND
  The emergence of minimally invasive techniques has broadened interest in splenectomy for a variety of haematological illnesses. Laparoscopic splenectomy (LS) is currently considered the gold standard for the treatment of various haematological disorders.
  
  
  OBJECTIVE
  The literature was reviewed to highlight points of consensus and debatable points regarding best practice in LS, looking at issues such as bleeding and conversion, splenomegaly, splenic retrieval techniques, types of instruments used, hand-assisted LS (HALS), complications, approaches, accessory spleen and splenosis. Our goal was to share our experience with LS and compare it with other reports.
  
  
  BACKGROUND
  LS has emerged as the standard of care for elective splenectomy for benign haematological diseases. However, doubts have been raised regarding the suitability of patients with splenomegaly for LS. There is also uncertainty about its efficacy in major trauma. HALS has emerged as an option for safe manipulation and splenic dissection.
  
  
  METHODS
  We performed 25 consecutive LSs at King Abdullah University Hospital (KAUH), Jordan, from 2001 to 2008. Patient demographics, operative time, intra- and postoperative complications, conversion rate, additional procedures and length of hospital stay were retrospectively reviewed.
  
  
  RESULTS
  The mean age of the patients was 38.8 years (range 11-77 years), mean operative time was 132 minutes (90- 170 minutes), and length of hospital stay was 2.9 (standard deviation 2.7) days. One case was converted to open surgery (5%). There was 1 case of superficial wound infection in the series (5%), and no deaths.
  
  
  CONCLUSIONS
  LS is a well- accepted minimally invasive procedure, but knowledge and skill are required to perform it with minimal morbidity and mortality.
authors.affiliation: King Abdullah University Hospital, Jordan. mohbanihani@hotmail.com
authors.forename: Mohammed N
authors.initials: MN
authors.lastname: Bani Hani
authors.forename: Ghazi R
authors.initials: GR
authors.lastname: Qasaimeh
authors.forename: Kamal E
authors.initials: KE
authors.lastname: Bani-Hani
authors.forename: Nizar R
authors.initials: NR
authors.lastname: Alwaqfi
authors.forename: Abdel Rahman A
authors.initials: AR
authors.lastname: Al Manasra
authors.forename: Yousef S
authors.initials: YS
authors.lastname: Matani
authors.forename: Khled M
authors.initials: KM
authors.lastname: El-Radaideh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D058733:Hand-Assisted Laparoscopy; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly; D055815:Young Adult