The role of hand-assisted laparoscopic splenectomy for mega spleens in the da Vinci era

Franco, Gregorio Di; Gianardi, Desirée; Bianchini, Matteo; Palmeri, Matteo; Morelli, Luca

doi:10.1007/s11701-019-00985-4

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…Currently, HALS is performed for gastric cancer as well as colon cancer, 9 gynecological diseases, 10 urinary system diseases, 11 and liver and spleen diseases. 12,13…”

Section: Discussionmentioning

confidence: 99%

“…Currently, HALS is performed for gastric cancer as well as colon cancer, 9 gynecological diseases, 10 urinary system diseases, 11 and liver and spleen diseases. 12,13 In HALS radical gastrectomy for gastric cancer, the complexity of the operation is greatly reduced compared with other methods because the auxiliary hand can provide tactile feedback and resist traction tissues. 14 Based on our clinical experience and previous studies, HALS has a short learning curve and is suitable for senior doctors with no basic knowledge of laparoscopic surgery and for primary hospitals.…”

Section: Discussionmentioning

confidence: 99%

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Hand-assisted laparoscopic versus laparoscopic-assisted radical gastrectomy in the treatment of advanced distal gastric cancer: final results of a single-center randomized study

Luo¹,

Qin²,

Wang³

et al. 2022

J Int Med Res

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Objective To compare the results and 5- and 8-year overall survival (OS) and disease-free survival (DFS) of hand-assisted laparoscopic surgery (HALS) and laparoscopic-assisted surgery (LAS) in radical gastrectomy for advanced distal gastric cancer. Methods A total of 124 patients admitted to our institution from May 2009 to April 2013 were randomly divided into a HALS group (n = 62) and a LAS group (n = 62). Postoperatively, 110 patients were followed for 5 and 8 years, and 14 patients were lost to follow-up. The 5- and 8-year OS and DFS rates of the groups were compared and analyzed. Results The 5- and 8-year OS rates, respectively, were 38.8% and 19.4% in the HALS group and 38.3% and 15.3% in the LAS group (log-rank test, χ2 = 0.250). The 5- and 8-year DFS rates, respectively, were 23.1% and 10.6% in the HALS group and 19.3% and 11.6% in the LAS group (log-rank test, χ2 = 0.109). No significant differences were found. Conclusion Compared with LAS, HALS radical gastrectomy for advanced distal gastric cancer had a lower conversion rate to open surgery, shorter surgical duration, and more thorough dissection of lymph nodes; 5- and 8-year OS and DFS rates were similar to those with LAS.

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“…Currently, HALS is performed for gastric cancer as well as colon cancer, 9 gynecological diseases, 10 urinary system diseases, 11 and liver and spleen diseases. 12,13…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hand-assisted laparoscopic versus laparoscopic-assisted radical gastrectomy in the treatment of advanced distal gastric cancer: final results of a single-center randomized study

Luo¹,

Qin²,

Wang³

et al. 2022

J Int Med Res

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“…[15][16][17] Se prefiere la esplenectomía laparoscópica para los tratamientos de enfermedades benignas y hematológicas secundarias a enfermedades de base, por mostrar ser un procedimiento seguro, baja morbilidad y ofrecer los beneficios de la cirugía de mínimo acceso, menor estancia hospitalaria, exposición quirúrgica, menor dolor y tiempo de recuperación. 3,5,14,15,17 En los pacientes con esplenomegalia masiva, la cual se define en bazos con diámetros de 20 cm o más en su eje mayor, 16,18 es un tema aún en controversia, debido a los múltiples retos relacionados con un bazo agrandado, como el espacio de trabajo limitado, dificultad en la retracción o movilización por las adherencias y riesgo de trauma vascular del hilio esplénico y la dificultad para la extracción de la pieza quirúrgica. En casos de esplenomegalia masiva se asocia a morbilidad posoperatoria que oscila entre 20-60%, sin importar el tipo de abordaje, abierto o de mínimo acceso; esto asociado a las comorbilidades y enfermedades de base que llevaron a la esplenomegalia.…”

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“…La esplenectomía laparoscópica mano asistida ha demostrado ventajas sobre la esplenectomía convencional en presencia de esplenectomía masiva, conserva la sensación táctil, la cual es útil para todo cirujano, facilita la movilización gentil del bazo, identificación hilio esplénico, la exposición de vasos cortos y del pedículo vascular para su disección, además de control en caso de eventual sangrado del mismo; sin perder las ventajas de la cirugía de mínimo acceso. 2,18 El aumento relativo de tiempo quirúrgico, necesidad de más incisiones, sangrado, dolor posoperatorio y morbilidad demostraron que la esplenectomía mano asistida no mejora los resultados en tiempo quirúrgico, dolor posoperatorio y estancia hospitalaria comparada con la laparoscópica convencional y que la primera técnica tenía la desventaja de requerir incisiones adicionales. 20 Litwin y colaboradores, en una serie multicéntrica, demostraron la utilidad de un puerto de mano en ocho casos de esplenomegalia.…”

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Esplenectomía laparoscópica mano asistida por esplenomegalia masiva

Ponce¹,

Pérez²,

Pérez³

et al. 2020

Revista Mexicana De Cirugía Endoscópica

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La cirugía de mínimo acceso ha evolucionado constantemente desde la década de 1980; múltiples centros a nivel internacional han desarrollado dispositivos y abordajes con la finalidad de minimizar el riesgo de sangrado, del dolor posoperatorio, de la estancia hospitalaria y los resultados estéticos. Dichos avances han catalogado al abordaje laparoscópico como la opción principal en la resección esplénica no urgente. Material y métodos: Se presenta el caso de paciente femenino de 74 años con múltiples comorbilidades, anemia crónica y dolor abdominal difuso, con predominio en cuadrante superior izquierdo, con esplenomegalia palpable hasta la cresta iliaca izquierda; ultrasonido y tomografía de abdomen con esplenomegalia 20 × 17 × 8 cm y volumen calculado de 1400 cm 3 . Esplenectomía mediante abordaje laparoscópico mano asistido con tres puertos y control vascular con endograpadora; bazo de 25 × 15 × 10 cm. Resultados: Evolución satisfactoria con egreso al cuarto día de posoperatorio, con resolución del motivo de consulta. Conclusión: La valoración integral de los pacientes con esplenomegalia masiva facilita el tratamiento operatorio. La esplenectomía laparoscópica mano asistida (HALS) es una opción viable, permite adecuada ABSTRACT Introduction: Minimally invasive surgery has constantly evolved since the 1980's; multiple international centres have developed devices and approaches with the intention of reducing the risk of haemorrhage, postoperative pain and hospital stay, as well as improving cosmetic results. These improvements have positioned laparoscopic approach as the main option for the non -urgent splenic resection. Methods and material: The case presents a 74-year-old female with multiple comorbidities, chronic anemia and difuse abdominal pain, predominant in the upper left cuadrant; palpable splenomegaly down to the left iliac crest; US and CT shows a 20 × 17 × 8 cm spleen, with a calculated volume of 1400 cm 3 . Hand-assisted laparoscopic approach is performed through 3 ports; vascular control with endostapler, finding a 25 × 15 × 10 cm spleen. Results: Satisfactory postoperative evolution and patient discharge at day 4 with significant haemoglobin rise and cese of abdominal pain. Conclusion:Integral selection and meeting of criteria in patients with massive splenomegalia, improves the surgical treatment. Hand-assisted laparoscopic splenectomy (HALS) is a viable option, which allows an optimized movility of the spleen and adjacent structures and which

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Robotic-assisted Partial Splenectomy

Gao,

Zhang

2023

Pediatric Robotic Surgery

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The role of hand-assisted laparoscopic splenectomy for mega spleens in the da Vinci era

Cited by 3 publications

References 12 publications

Hand-assisted laparoscopic versus laparoscopic-assisted radical gastrectomy in the treatment of advanced distal gastric cancer: final results of a single-center randomized study

Hand-assisted laparoscopic versus laparoscopic-assisted radical gastrectomy in the treatment of advanced distal gastric cancer: final results of a single-center randomized study

Esplenectomía laparoscópica mano asistida por esplenomegalia masiva

Robotic-assisted Partial Splenectomy

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