+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Laparoscopic treatment of splenomegaly: a case for hand-assisted laparoscopic surgery



Laparoscopic treatment of splenomegaly: a case for hand-assisted laparoscopic surgery



Archives of Surgery 146(7): 818-823



Hand-assisted laparoscopic surgery (HALS) is a safe therapeutic approach to remove megaspleens of any size. Conventional laparoscopic splenectomy for splenomegaly is difficult because of limited exposure and complex vascular control, with increased risk of intraoperative bleeding and conversion to open surgery. HALS can overcome some of these limitations, reducing the risk of conversion to open surgery and resulting in a postoperative course similar to that of conventional laparoscopy. Single-institution single-surgeon retrospective review. University hospital. An analysis was performed of all patients with splenomegaly (splenic weight, >7 g) seen during a 1-year period.Main Outcome Measures Preoperative data, indications for splenectomy, splenic weight, operative variables, clinical outcome, and rates of conversion to open surgery, complications, and operative mortality were compared between patients undergoing HALS vs conventional laparoscopy. Splenomegaly was present in 85 patients, of whom 43 underwent HALS splenectomy and 42 underwent conventional laparoscopic splenectomy. The HALS group had larger spleens. Rates of conversion to open surgery and operative mortality were similar in the HALS group vs the conventional laparoscopy group (2.3% [1 of 43] vs 2.4% [1 of 42] and 2.3% [1 of 43] vs .% [ of 42], respectively), with no difference in hospital length of stay in the absence of morbidity. Portal system thrombosis was the most serious complication. HALS can minimize surgical trauma in patients with massive splenomegaly who otherwise would be candidates only for open surgery and results in a clinical outcome similar to that of conventional laparoscopy. With the availability of HALS, any patient with splenomegaly can be offered a minimally invasive surgical option. Portal system thrombosis is common, regardless of the surgical technique.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036151859

Download citation: RISBibTeXText

PMID: 21768428

DOI: 10.1001/archsurg.2011.149


Related references

T1637 Single Incision Laparoscopic Surgery (Sils) Versus Hand Assisted Laparoscopic Surgery (Hals): A Case-Matched Series. Gastroenterology 138(5): S-884, 2010

Comparison of short-term outcomes of hand-assisted laparoscopic, laparoscopic, and open surgery in the treatment of rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi 17(6): 574-577, 2014

Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. Journal of the American College of Surgeons 213(1): 72-80; Discussion 80-2, 2011

Comparison of Gas-less laparoscopy-assisted surgery, hand-assisted laparoscopic surgery and pure laparoscopic surgery for radical nephrectomy. International Journal of Urology 11(3): 142-147, 2004

Hand-assisted laparoscopic splenectomy (HALS) in cases of splenomegaly: a comparison analysis with conventional laparoscopic splenectomy. Surgical Endoscopy 16(3): 426-430, 2002

Hand-assisted laparoscopic splenectomy for splenomegaly: a comparative study with conventional laparoscopic splenectomy. Chinese Medical Journal 120(1): 41-45, 2007

Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly. Archives of Surgery 137(12): 1348-1352, 2002

Hand-assisted Laparoscopic Splenectomy Advantages Over Complete Laparoscopic Splenectomy For Splenomegaly. Surgical Laparoscopy Endoscopy and Percutaneous Techniques 29(2): 109-112, 2019

Hand-assisted laparoscopic splenectomy is a useful surgical treatment method for patients with excessive splenomegaly: A meta-analysis. World Journal of Clinical Cases 7(3): 320-334, 2019

A comparison of hand-assisted laparoscopic surgery and conventional laparoscopic surgery in rectal cancer: a propensity score analysis. Surgical Endoscopy 30(6): 2449-2456, 2016

Hand-Assisted Laparoscopic Surgery Versus Conventional Laparoscopic Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis. Journal of Laparoendoscopic and Advanced Surgical Techniques. Part a 27(12): 1251-1262, 2017

Hand-assisted laparoscopic surgery vs standard laparoscopic surgery for colorectal disease: a prospective randomized trial. HALS Study Group. Surgical Endoscopy 14(10): 896-901, 2000

Comparison and short-term outcomes between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for anterior resections of left-sided colon cancer. International Journal of Colorectal Disease 25(8): 975-981, 2010

Hand-assisted laparoscopic surgery (HALS): a bridge to complex laparoscopic procedures. Jsls 9(2): 123-124, 2005

Hand-assisted laparoscopic surgery versus laparoscopic right colectomy: a meta-analysis. World Journal of Surgical Oncology 15(1): 215, 2017