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Guidelines for the performance of minimally invasive splenectomy
Tammy L Kindel1, Rebecca C Dirks2, Amelia T Collings2
1Department of Surgery, Medical College of Wisconsin, Wauwatosa, USA.
Surgical Endoscopy
|September 28, 2021
Summary
Minimally invasive splenectomy (MIS) guidelines offer evidence-based recommendations for spleen surgery. These guidelines focus on specific techniques and peri-operative care to improve patient outcomes in MIS procedures.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Minimally invasive splenectomy (MIS) is preferred over open surgery for spleen diseases.
- While MIS offers benefits like reduced morbidity, optimal technical and peri-operative strategies require clarification.
Purpose of the Study:
- To establish evidence-based guidelines for the peri-operative management of MIS.
- To support clinicians and patients in making informed decisions regarding MIS.
Main Methods:
- A SAGES guidelines committee utilized the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
- A systematic review of evidence informed the development of recommendations.
Main Results:
- Eight recommendations were formulated for elective MIS in adults and children.
- Key areas addressed include patient positioning, splenic hilum control, and drain placement.
Conclusions:
- Conditional recommendations favor lateral positioning for non-hematologic spleen disease.
- Intra-operative platelet administration is recommended for idiopathic thrombocytopenic purpura over pre-operative administration.
- Routine intra-operative drain placement is not recommended.
Keywords:
Clinical practice guidelinesLaparoscopic splenectomyMinimally invasive splenectomySplenic artery embolizationSurgical drain
