title: Transumbilical single-incision endoscopic splenectomy: report of ten cases.
abstract: OBJECTIVE
  To investigate the feasibility and clinical application of transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments.
  
  
  METHODS
  Between 2010 and 2012, transumbilical single-incision endoscopic splenectomy was performed in 10 patients in our department, of whom 4 had refractory idiopathic thrombocytopenic purpura, 4 had enlarged splenic cyst and 2 had splenic hematoma. A 2.5-cm curved incision was made at the lower umbilicus edge, and a 10 mm laparoscope was inserted into the middle of the incision. A 5-mm harmonic scalpel was placed on the right side, and a 5-mm auxiliary instrument on the left side of the laparoscope. Splenic ligaments were incised with a harmonic scalpel, and the splenic pedicle was cut with an Endo-gastrointestinal anastomosis. The spleen was dissected and placed in a large retrieval bag, blended, and then removed.
  
  
  RESULTS
  All transumbilical single-incision endoscopic splenectomies were performed successfully with mean operative time of 80 ± 5 min and mean blood loss of 150 ± 20 mL. Conversion to laparotomy or multi-port laparoscopic surgery was not required in all cases. All patients were discharged on postoperative days 4-6. During the postoperative hospitalization period, no painkillers were required. No intra-abdominal complications such as infection, ascites, gastric leakage, pancreatic leakage, or wound infection occurred in any case during the 6-mo follow-up.
  
  
  CONCLUSIONS
  Transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments is technically feasible and safe in selected patients.
authors.affiliation: Zhi-Wei Liang, Yuan-Cheng, Ze-Sheng Jiang, Hai-Yan Liu, Yi Gao, Ming-Xin Pan, Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Liang
authors.affiliation: Zhi-Wei Liang, Yuan-Cheng, Ze-Sheng Jiang, Hai-Yan Liu, Yi Gao, Ming-Xin Pan, Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Zhi-Wei Liang, Yuan-Cheng, Ze-Sheng Jiang, Hai-Yan Liu, Yi Gao, Ming-Xin Pan, Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
authors.forename: Ze-Sheng
authors.initials: ZS
authors.lastname: Jiang
authors.affiliation: Zhi-Wei Liang, Yuan-Cheng, Ze-Sheng Jiang, Hai-Yan Liu, Yi Gao, Ming-Xin Pan, Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Liu
authors.affiliation: Zhi-Wei Liang, Yuan-Cheng, Ze-Sheng Jiang, Hai-Yan Liu, Yi Gao, Ming-Xin Pan, Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Zhi-Wei Liang, Yuan-Cheng, Ze-Sheng Jiang, Hai-Yan Liu, Yi Gao, Ming-Xin Pan, Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
authors.forename: Ming-Xin
authors.initials: MX
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013158:Splenic Diseases / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*; D055815:Young Adult
keywords: Intra-abdominal complications; Single-incision endoscopic surgery; Splenectomy; Transumbilical single-incision endoscopic splenectomy