Single-incision laparoscopic splenectomy.
OBJECTIVE
The single-incision approach in laparoscopic surgery is a relatively new concept. This systematic review of the literature was performed to appraise the existing clinical evidence concerning the use of the single-incision technique for spleen resection.


METHODS
We performed a systematic search of the PubMed and Scopus databases, and the studies retrieved were included in our review. The references of the included studies were also hand searched.


RESULTS
Thirty-one relevant studies were found in the field including 81 patients with an age range from 0.6 to 90 years and a body mass index range from 18 to 36.7 kg/m2. Splenomegaly (44.6%), idiopathic thrombocytopenic purpura (31%), and immune thrombocytopenic purpura (6.8%) were the most common indications for the procedure. Concerning the applied port system, multiple single ports (5 to 12 mm) were used in 54.4% of patients, the SILS port (Covidien, Mansfield, Massachusetts) was used in 26.6%, the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) was used in 7.6%, glove ports were used in 6.3%, and the GelPort (Applied Medical, Rancho Santa Margarita, California) was used in 5.1%. The median operative time was 125 minutes (range, 45-420 minutes), and the median quantity of blood loss was 50 mL (range, 10-450 mL). No conversion to open surgery and no transfusion were needed. The length of hospital stay was between 1 and 9 days. Low rates of complications and no patient deaths were found. The existing evidence on cosmesis is limited.


CONCLUSIONS
Single-site/single-port laparoscopic surgery is a minimally invasive procedure that seems to be a challenging alternative in the management of spleen resection.
First Department of Surgery, General Hospital of Attica "KAT," Athens, Greece.
Ioannis D
ID
Gkegkes
Department of Surgery, Korinthos General Hospital, Corinth, Greece.
Sarantis
S
Mourtarakos
Gynaecological Oncology Department, Royal Surrey County Hospital, Guildford, England.
Christos
C
Iavazzo
D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D061646:Operative Time; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D013154:Spleen / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*
Laparoendoscopic single site; Single incision; Splenectomy