Positioning for Emergency Laparoscopic Splenectomy for Traumatic Splenic Rupture

Area of Science:

• Surgical Innovation
• Trauma Surgery
• Minimally Invasive Procedures

Background:

• Traumatic splenic rupture is a significant cause of morbidity and mortality.
• Laparoscopic surgery (LS) offers advantages over open procedures for splenic injuries.
• Optimal patient positioning during LS for traumatic splenic rupture requires further investigation.

Purpose of the Study:

• To compare the efficacy of the right-lateral decubitus position versus the supine position for emergency laparoscopic surgery in patients with traumatic splenic rupture.
• To evaluate the impact of surgical positioning on key operative and postoperative outcomes.

Main Methods:

• A descriptive study analyzed clinical data from 96 patients undergoing LS for traumatic splenic rupture.
• Patients were divided into two groups: right-lateral decubitus (n=42) and supine (n=54).
• Outcomes including operation time, blood loss, conversion rates, and complications were compared.

Main Results:

• The right-lateral decubitus group demonstrated significantly shorter operation times (145.5 vs. 169.0 min) and less intraoperative blood loss (75.3 vs. 110.3 ml).
• Fewer conversions to laparotomy (2.4% vs. 16.7%) and lower rates of postoperative pancreatic leakage (7.1% vs. 24.1%) were observed in the right-lateral decubitus group.
• Overall complication rates were significantly lower in the right-lateral decubitus position (23.8% vs. 53.7%).

Conclusions:

• The right-lateral decubitus position is the preferred surgical position for emergency laparoscopic surgery in patients with traumatic splenic rupture.
• This positioning strategy enhances surgical efficiency and patient safety by reducing operative time, blood loss, and complications.