Hansen Erik N, Muensterer Oliver J
Division of Pediatric Surgery, Children's Hospital of Alabama, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.
JSLS. 2010 Apr-Jun;14(2):286-8. doi: 10.4293/108680810X12785289144809.
Single incision laparoscopic surgery (SILS) is an emerging technique that has been used as an approach for appendectomy, cholecystectomy, and splenectomy. We describe the technique of single incision laparoscopic splenectomy for hypersplenism in a 5-year-old boy with spherocytosis.
The patient required blood transfusions for anemia secondary to hypersplenism. His spleen measured 9.8 cm in cranio-caudal length on ultrasound. SILS splenectomy was performed through a 2-cm umbilical incision by using 3 ports. The splenic attachments were taken down using an electrosurgical sealing and cutting device, and the hilum was transected with an endosurgical stapler. The spleen was placed in an endosurgical bag, morcellated, and removed from the abdomen via the umbilical incision without complications. Operative time was 84 minutes; blood loss was minimal.
SILS splenectomy is feasible in pediatric patients. More experience is needed to assess advantages and disadvantages compared with the standard laparoscopic approach.
单孔腹腔镜手术（SILS）是一种新兴技术，已被用作阑尾切除术、胆囊切除术和脾切除术的手术方式。我们描述了一名5岁球形红细胞增多症男孩因脾功能亢进接受单孔腹腔镜脾切除术的技术。
该患者因脾功能亢进继发贫血需要输血。超声检查显示其脾脏头尾径长9.8厘米。通过一个2厘米的脐部切口，使用3个端口进行单孔腹腔镜脾切除术。使用电外科密封切割装置分离脾脏附着处，并用内镜吻合器横断脾门。将脾脏放入内镜手术袋中，切碎后通过脐部切口从腹部取出，无并发症发生。手术时间为84分钟；失血极少。
单孔腹腔镜脾切除术在儿科患者中是可行的。与标准腹腔镜手术方法相比，需要更多经验来评估其优缺点。
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