title: Single-incision laparoscopic splenectomy: preliminary experience in consecutive patients and comparison to standard laparoscopic splenectomy.
abstract: BACKGROUND
  Since first being described in 2009, single-incision laparoscopic splenectomy has been described in a limited number of case reports and small case series. No studies have evaluated single-incision splenectomy in unselected patients, and outcomes of the procedure have not previously been compared to standard laparoscopy.
  
  
  METHODS
  A retrospective review was conducted to evaluate all single-incision splenectomies performed by a single surgeon between June 2010 and June 2011. Additionally, patients who underwent standard laparoscopic splenectomy by surgeons in the same tertiary referral surgical oncology group were evaluated to serve as a control group. Demographic data, operative parameters, and postoperative outcomes were assessed.
  
  
  RESULTS
  Eight patients underwent successful single-incision splenectomy during the study period without conversion to an open procedure or requiring additional ports. The median operative time was 92.5 min. There was 25 % morbidity and no mortality in the study group. Median length of stay was 4 days. Additionally, 18 patients who underwent standard laparoscopic splenectomy were evaluated for comparison. No significant differences were identified in the preoperative patient characteristics between the two groups. Single-incision splenectomy was associated with a shorter operative time (92.5 vs. 172 min, p = 0.003), lower conversion rate, equivalent length of stay, reduced mortality, similar morbidity, and comparable postoperative narcotic requirements.
  
  
  CONCLUSIONS
  Single-incision splenectomy is feasible, safe, and efficient in an unselected patient population in the hands of an experienced laparoscopic surgeon. The single-incision technique is comparable to standard laparoscopic splenectomy in terms of operative time and perioperative outcomes.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Pittsburgh Medical Center, 5150 Centre Ave., Suite 420, Pittsburgh, PA 15232, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Boone
authors.forename: Patrick
authors.initials: P
authors.lastname: Wagner
authors.forename: Emily
authors.initials: E
authors.lastname: Ganchuk
authors.forename: Leonard
authors.initials: L
authors.lastname: Evans
authors.forename: Steven
authors.initials: S
authors.lastname: Evans
authors.forename: Herb J
authors.initials: HJ
authors.lastname: Zeh
authors.forename: David L
authors.initials: DL
authors.lastname: Bartlett
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Holtzman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult