Park A, Gagner M, Pomp A
Department of Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
Am J Surg. 1997 Feb;173(2):126-30. doi: 10.1016/S0002-9610(97)89602-X.
Laparoscopic splenectomy has been shown to result in shorter hospital stays and a quicker return to work than conventional splenectomy. Having tried the anterior 5 trocar approach, we developed a 4 trocar lateral approach and now present our experience with 22 cases.
All patients were placed in the right lateral decubitus position. A 10-mm trocar was inserted in the left subcostal region, 2 in the flank, and a 5-mm trocar dorsally. A 30 degrees laparoscope was used. Splenectomy was performed for varying pathologies.
Operating room (OR) time averaged 169 minutes, spleen weight 513 grams, and postoperative (post-op) stays 5.4 days (median 3 days). One patient was converted to laparotomy. There were no deaths, post-op abscesses, pancreatic injuries, or bleeding complications.
The lateral approach affords superior exposure, allowing easier dissection of splenic hilar structures. Over varying patient habitus and spleen size it has been demonstrated to be the approach of choice for laparoscopic splenectomy.
与传统脾切除术相比，腹腔镜脾切除术已被证明可缩短住院时间并更快恢复工作。在尝试了前入路五套管法后，我们开发了一种四套管侧入路法，现介绍我们22例患者的经验。
所有患者均取右侧卧位。在左肋下区域插入一个10毫米套管针，在侧腹插入两个，在背部插入一个5毫米套管针。使用30度腹腔镜。针对不同病理情况进行脾切除术。
手术时间平均为169分钟，脾脏重量为513克，术后住院时间为5.4天（中位数为3天）。1例患者转为开腹手术。无死亡、术后脓肿、胰腺损伤或出血并发症。
侧入路提供了更好的视野，便于更轻松地解剖脾门结构。在不同体型和脾脏大小的患者中，已证明该入路是腹腔镜脾切除术的首选方法。
