A ten-year, single institution experience with laparoscopic splenectomy

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Laparoscopic splenectomy (LS) is the standard of care for specific spleen diseases.
• While safety and feasibility are documented, long-term outcome data for LS are limited.
• This study presents a 10-year institutional experience with LS to analyze procedural outcome trends.

Purpose of the Study:

• To evaluate long-term procedural outcomes of laparoscopic splenectomy.
• To identify trends in safety and efficacy over a decade of practice.
• To compare early versus later patient cohorts undergoing LS.

Main Methods:

• A 10-year prospective study (1992-2001) of 109 unselected patients undergoing LS for hematological diseases.
• Patients were divided into two cohorts: the first 55 (Group I) and the subsequent 54 (Group II).
• Data were collected via a longitudinal database, medical records, and patient interviews, analyzed using the unpaired Student t test.

Main Results:

• Operative time was similar between groups (151 min vs. 159 min).
• Estimated blood loss significantly decreased from 544 mL in Group I to 308 mL in Group II (P=0.015).
• Conversion rate to open surgery decreased from 13% in Group I to 2% in Group II (P<0.05).
• Mean spleen specimen weight increased significantly from 288 g in Group I to 512 g in Group II (P=0.03).
• Morbidity rates were comparable (13% vs. 9%).

Conclusions:

• Laparoscopic splenectomy is a safe and effective procedure for diverse indications over a 10-year period.
• Despite increasing spleen size, significant improvements in blood loss and conversion rates were achieved.
• LS demonstrates favorable long-term outcomes and evolving procedural efficiency.