Lee Wei-Feng, Wu Shih-Chung, Yong Chee-Chien, Chen Chao-Long, Wang Chih-Chi
Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang Gung Med J. 2010 Jan-Feb;33(1):67-72.
A hand-assisted laparoscopic procedure allows the surgeon to insert the nondominant hand into the abdomen, and helps to recover the tactile sensation. For a massively enlarged spleen, this technique overcomes difficulty in conventional laparoscopic splenectomy. The advantages of minimally-invasive surgery can still be preserved. We describe our preliminary experience in hand-assisted laparoscopic splenectomy.
The data of 5 patients who presented with splenomegaly and underwent hand-assisted laparoscopic splenectomy between April 2000 and January 2004 were reviewed retrospectively for analysis.
The mean age was 45.4 +/- 6.6 years, and the hospital stay was 6.6 +/- 1.0 days. The splenic length and weight averaged 20.6 +/- 5.9 cm and 1084.2 +/- 647.8 g. The operative time and blood loss averaged 218.2 +/- 40.2 minutes and 220 +/- 166.1 ml. There was no conversion to open splenectomy. No mortality or morbidity was noted in our series.
Hand-assisted laparoscopic splenectomy is a safe and feasible procedure, even in our initial experience. It helps in exploration of the surgical field and handling of a fragile spleen, especially in patients with massively enlarged spleens. Although another incision is necessary, the advantages of laparoscopic surgery are still retained.
手辅助腹腔镜手术允许外科医生将非优势手插入腹腔，有助于恢复触觉。对于巨大脾脏，该技术克服了传统腹腔镜脾切除术的困难。微创手术的优势仍可保留。我们描述了我们在手辅助腹腔镜脾切除术中的初步经验。
回顾性分析2000年4月至2004年1月间5例脾肿大并接受手辅助腹腔镜脾切除术患者的数据进行分析。
平均年龄为45.4±6.6岁，住院时间为6.6±1.0天。脾脏长度和重量平均分别为20.6±5.9厘米和1084.2±647.8克。手术时间和失血量平均分别为218.2±40.2分钟和220±166.1毫升。无一例转为开腹脾切除术。我们的系列中未观察到死亡或并发症。
即使在我们的初步经验中，手辅助腹腔镜脾切除术也是一种安全可行的手术。它有助于手术视野的探查和处理脆弱的脾脏，特别是在脾脏巨大的患者中。虽然需要另做一个切口，但腹腔镜手术的优势仍然保留。
