Laparoscopic Splenectomy: Consensus and Debatable Points (General Surgery) (Clinical Report‪)‬

Splenectomy is an established therapeutic intervention for benign haematological disorders. Laparoscopic splenectomy (LS) has become accepted as an alternative to the open procedure. First described in 1991 by Delaitre et al., (1) this technique became more popular after the introduction of newer instruments that made dissection easier, shortened operative time and decreased blood loss. Like other laparoscopic procedures, LS has proved to have advantages over open splenectomy (OS) with regard to aspects such as decreased postoperative pain, shorter hospital stay, faster functional recovery and a lower rate of complications (pneumonia and ileus). (2-5) The spleen is located deep in the abdominal cavity, and laparoscopy improves exposure to it. (6,7) Originally LS was considered ideal for normal-sized and mildly enlarged spleens, but nowadays it is being increasingly used in patients with splenomegaly. (8) In most published papers the rate of conversion from a laparoscopic to an open procedure is reported as between 2% and 10%, (4,9) with splenomegaly and bleeding the factors most commonly leading to conversion. Like laparoscopic cholecystectomy, anti-reflux surgery and gastric cancer procedures, LS is currently considered the gold standard and is used for the treatment of various haematological disorders. (10-13) Materials and methods