Laparoscopic Splenectomy Outcomes and Techniques
Summary
Since its inception in 1991, laparoscopic splenectomy has become the preferred approach for elective removal of the spleen, offering reduced postoperative pain, shorter hospitalisation and superior cosmetic results compared with open surgery. Technical refinements—including hand-assisted access, single-incision entry and robotic platforms—have broadened indications to include massive splenomegaly and trauma. Outcome analyses demonstrate low conversion and mortality rates; perioperative morbidity is chiefly influenced by spleen size, underlying pathology and surgeon experience. Vascular complications such as portal vein system thrombosis and postoperative pancreatic fistula remain concerns, driving the adoption of standardised dissection planes, energy-device protocols and enhanced recovery pathways. Advanced preoperative imaging and intraoperative guidance tools are helping to predict difficult cases and tailor the surgical approach, thereby optimising global applicability and reinforcing laparoscopic splenectomy’s role as a minimally invasive standard.
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Laparoscopic Splenectomy Outcomes and Techniques publication trend
The graph below shows the total number of articles in laparoscopic splenectomy outcomes and techniques across all publications each year (not limited to Nature Index journals).
Technical terms
Laparoscopic splenectomy: Minimally invasive removal of the spleen using trocar-based access and camera guidance.
Hand-assisted laparoscopic splenectomy (HALS): A hybrid technique that incorporates a small hand port to facilitate mobilisation and extraction of large spleens.
Totally laparoscopic splenectomy (TLS): A fully port-based approach without additional hand ports or extensions.
Portal vein system thrombosis (PVST): Postoperative clot formation in the portal or splenic vein, potentially leading to portal hypertension.
Postoperative pancreatic fistula (POPF): Leakage of pancreatic fluid from the transected tail, graded by severity and requiring specific management.
References
- Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases. Journal of Clinical Medicine (2018).
- Surgery for massive splenomegaly. BJS Open (2017).
- Laparoscopic splenectomy in a case of blunt abdominal trauma. Journal of Minimal Access Surgery (2009).
- Single-port splenectomy: Current update and controversies. Journal of Minimal Access Surgery (2011).
- Robotic-Assisted Splenectomy by a Modified Lateral Approach: Technique and Outcomes. Cureus (2023).
- Short- and long-term outcomes of 486 consecutive laparoscopic splenectomy in a single institution. Medicine (2021).
- Pancreatic Fistula and Biochemical Leak after Splenectomy: Incidence and Risk Factors—A Retrospective Single-Center Analysis. Langenbeck's Archives of Surgery (2022).
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