Laparoscopic splenectomy in a minimal resource setting: a case series from the Caribbean

This study examines the perioperative outcome of laparoscopic splenectomy in a minimal resources setting in the Caribbean. Seventeen consecutive patients who underwent elective laparoscopic splenectomies by a single surgeon from August 2003 to December 2008 were studied. Data collected included patients' demographics, indications for surgery, operative time, complications, and outcome. 88% were females, the median age being 33.3 years. Idiopathic thrombocytopenic purpura was the most common indication (82%) in majority of the cases. Other indications included hereditary spherocytosis, hypersplenism, and metastatic disease. The mean operative time was 88.8 minutes and the mean hospital length of stay was 3.3 days. One case was converted to open splenectomy. Five patients experienced postoperative complications. There was no mortality. Despite limited blood banking facilities and hematology support, laparoscopic splenectomy may be safe in minimal resources setting, if cases are selected carefully and performed by an experienced surgeon with short operative times.