• Laparoscopy
• Paediatric surgery
• Splenomegaly
• Surgical modality
• Surgical outcome

• Humans
• Child
• Splenomegaly/etiology
• Splenomegaly/surgery
• Retrospective Studies
• Length of Stay
• Spleen
• Splenectomy/methods
• Laparoscopy/methods
• Surgical Wound/complications
• Treatment Outcome

• 2020KY03022 Middle-aged and Young Teachers' Basic Ability Promotion Project of Guangxi
• 2021KY0084 Middle-aged and Young Teachers' Basic Ability Promotion Project of Guangxi
• S2019104 Guangxi Zhuang Autonomous Region Health and Family Planning Commission
• S20180943 Guangxi Zhuang Autonomous Region Health and Family Planning Commission
• 2021JJA140870 Natural Science Foundation of Guangxi Province
• 82060129 Innovative Research Group Project of the National Natural Science Foundation of China

• Hepatocellular carcinoma
• Laparoscopy
• Single port
• Solo surgery

• gastric diseases
• laparoscopy
• meta-analysis
• multi-port
• reduced-port

• Equipment and Supplies/adverse effects
• Equipment and Supplies/standards
• Humans
• Laparoscopy/instrumentation
• Laparoscopy/methods
• Laparoscopy/standards
• Length of Stay/trends
• Operative Time
• Postoperative Complications/etiology
• Stomach Diseases/complications
• Stomach Diseases/surgery
• Treatment Outcome

• none none

• Appendectomy
• cholecystectomy
• laparoscopic surgery
• laparoscopy
• single incision
• splenectomy

Single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisional morbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy.

This study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopic distal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parameters evaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion, and final pathology.

There were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortality in either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneously in each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a mean of 180 minutes for Group 1 (p<0.001). One of the procedures in Group 2 was converted to open surgery due to peroperative bleeding. The median follow-up periods of the patients were 22 months and 56 months. The spleen was preserved in only 1 patient from Group 1, whereas in Group 2, the spleen preservation was achieved in 5 patients.

The single-incision laparoscopic technique is a safe and effective alternative to standard laparoscopic distal pancreatectomy.

• Laparoscopic surgery
• laparoscopik distal pancreatectomy
• minimally invasive surgery
• pancreas resection
• single-incision laparoscopic surgery

• SILS
• SIPES splenectomy
• single port
• splenectomy

To evaluate the clinical advantages of single-port laparoscopic hepatectomy (SPLH) compare to multi-port laparoscopic hepatectomy (MPLH).

We retrospectively reviewed the medical records of 246 patients who underwent laparoscopic liver resection between January 2008 and December 2015 at our hospital. We divided the surgical technique into two groups; SPLH and MPLH. We performed laparoscopic liver resection for both benign and malignant disease. Major hepatectomy such as right and left hepatectomy was also done with sufficient disease-free margin. The operative time, the volume of blood loss, transfusion rate, and the conversion rate to MPLH or open surgery was evaluated. The post-operative parameters included the meal start date after operation, the number of postoperative days spent in the hospital, and surgical complications was also evaluated.

Of the 246 patients, 155 patients underwent SPLH and 91 patients underwent MPLH. Conversion rate was 22.6% in SPLH and 19.8% in MPLH (P = 0.358). We performed major hepatectomy, which was defined as resection of more than 2 sections, in 13.5% of patients in the SPLH group and in 13.3% of patients in the MPLH group (P = 0.962). Mean operative time was 136.9 ± 89.2 min in the SPLH group and 231.2 ± 149.7 min in the MPLH group (P < 0.001). The amount of blood loss was 385.1 ± 409.3 mL in the SPLH group and 559.9 ± 624.9 mL in the MPLH group (P = 0.016). The safety resection margin did not show a significant difference (0.84 ± 0.84 cm in SPLH vs 1.04 ± 1.22 cm in MPLH, P = 0.704). Enteral feeding was started earlier in the SPLH group (1.06 ± 0.27 d after operation) than in the MPLH group (1.63 ± 1.27 d) (P < 0.001). The mean hospital stay after operation was non-significantly shorter in the SPLH group than in the MPLH group (7.82 ± 2.79 d vs 7.97 ± 3.69 d, P = 0.744). The complication rate was not significantly different (P = 0.397) and there was no major perioperative complication or mortality case in both groups.

Single-port laparoscopic liver surgery seems to be a feasible approach for various kinds of liver diseases.

• Hepatectomy
• Laparoscopy
• Minimally invasive surgery
• Treatment outcome
• Feasibility study

• Adult
• Aged
• Blood Loss, Surgical/statistics & numerical data
• Blood Transfusion/statistics & numerical data
• Conversion to Open Surgery/statistics & numerical data
• Feasibility Studies
• Female
• Hepatectomy/adverse effects
• Hepatectomy/methods
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Length of Stay/statistics & numerical data
• Liver Diseases/surgery
• Male
• Margins of Excision
• Middle Aged
• Operative Time
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Retrospective Studies
• Treatment Outcome

• laparoscopic
• meta-analysis
• single-incision laparoscopic surgery splenectomy
• splenectomy

• SILS
• SILSG
• bariatric surgery
• less
• obesity surgery
• single-incision sleeve gastrectomy

• laparoscopy
• pediatric
• reduced-port
• splenectomy

The single-incision approach in laparoscopic surgery is a relatively new concept. This systematic review of the literature was performed to appraise the existing clinical evidence concerning the use of the single-incision technique for spleen resection.

We performed a systematic search of the PubMed and Scopus databases, and the studies retrieved were included in our review. The references of the included studies were also hand searched.

Thirty-one relevant studies were found in the field including 81 patients with an age range from 0.6 to 90 years and a body mass index range from 18 to 36.7 kg/m². Splenomegaly (44.6%), idiopathic thrombocytopenic purpura (31%), and immune thrombocytopenic purpura (6.8%) were the most common indications for the procedure. Concerning the applied port system, multiple single ports (5 to 12 mm) were used in 54.4% of patients, the SILS port (Covidien, Mansfield, Massachusetts) was used in 26.6%, the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) was used in 7.6%, glove ports were used in 6.3%, and the GelPort (Applied Medical, Rancho Santa Margarita, California) was used in 5.1%. The median operative time was 125 minutes (range, 45–420 minutes), and the median quantity of blood loss was 50 mL (range, 10–450 mL). No conversion to open surgery and no transfusion were needed. The length of hospital stay was between 1 and 9 days. Low rates of complications and no patient deaths were found. The existing evidence on cosmesis is limited.

Single-site/single-port laparoscopic surgery is a minimally invasive procedure that seems to be a challenging alternative in the management of spleen resection.

• Laparoendoscopic single site
• Single incision
• Splenectomy

Single-port laparoscopic splenectomy has been performed sporadically. The aim of this study is to assess our experience with single-port laparoscopic splenectomy compared to conventional multiport laparoscopic surgery for the usual treatment modality for various kinds of splenic disease.

Between October 2008 to February 2014, 29 patients underwent single-port laparoscopic splenectomy and 32 patients received multiport laparoscopic splenectomy. We retrospectively analyzed the clinical outcomes of single-port group and multiport group.

The body mass index and disease profiles of the both groups were similar. The operative times of single-port and multiport group were 113.6 ± 39.9 and 95.9 ± 38.9 minutes, respectively (P = 0.946). The operative blood loss of the two groups were 295.8 ± 301.3 and 322.5 ± 254.5 mL (P = 0.582). Postoperative retrieved splenic weight of the single-port and multiport groups were 283.9 ± 300.7 and 362.3 ± 471.8 g, respectively (P = 0.261). One single-port partial splenectomy and 6 multiport partial splenectomies were performed in this study. There was one intraoperative gastric wall injury. It occurred in single-port group, which was successfully managed during the operation. Each case was converted to laparotomy in both groups due to bleeding. There was one mortality case in the multiport laparoscopic splenectomy group, which was not related to the splenectomy. Mean hospital stay of the single-port and multiport group was 5.8 ± 2.5 and 7.3 ± 5.2 days respectively (P = 0.140).

Single-port laparoscopic splenectomy seems to be a feasible approach for various kinds of splenic disease compared to multiport laparoscopic surgery.

• Laparoscopy
• Splenectomy

• Immune thrombocytopenic purpura
• single incision laparoscopic surgery
• single port
• single port access-laparoscopic splenectomy
• splenectomy

• Laparoscopic liver resection
• reduced port surgery
• single incision laparoscopic surgery

• Equipment Design
• Hepatectomy/methods
• Humans
• Laparoscopes
• Laparoscopy/methods
• Liver Neoplasms/surgery

Minimally invasive techniques have been introduced to reduce morbidity related to standard laparoscopic procedures. One such approach is laparoendoscopic single-site surgery. The aim of the study was to present our initial clinical experience of using this technique for elective splenectomy. We carried out single access laparoscopic splenectomy (SALS) for an 8 cm cystic lesion of the spleen, involving the hilum, on a 38-year-old woman. The procedure was performed with a single-port device (4-channel) via a 2.5-cm umbilical incision. A flexible 5-mm optic and straight laparoscopic instruments were used. The operative time was 75 min. There was no blood loss. No complications were observed. The postoperative period was uneventful. Although substantial development of the instruments and skills is needed, this SALS technique appears to be feasible and safe. Nevertheless, further experience and observations are necessary.

• laparoscopic splenectomy
• laparoscopy
• minimally invasive splenic surgery
• single incision laparoscopic surgery
• spleen

• Adolescent
• Adult
• Aged
• Feasibility Studies
• Female
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Length of Stay
• Male
• Middle Aged
• Morbidity
• Operative Time
• Postoperative Complications
• Retrospective Studies
• Splenectomy/adverse effects
• Splenectomy/methods
• Splenectomy/mortality
• Young Adult

Formerly, open splenectomy represented the conventional surgical treatment for many hematologic diseases. Currently, thanks to permanent technical development and improved skills, also laparoscopic splenectomy (LS) has become a recognized procedure in the treatment of spleen diseases, even in case of splenomegaly. A systematic review was performed with the aim of recalling the proved concepts of this surgical treatment and to browse new devices and techniques and their impact on the surgical outcome. The literature search was initially conducted in PubMed by entering general queries related to LS. The record identified through PubMed searching (n = 1599) was then screened by applying several criteria (study published in English from 1991 to 2013 with abstract available, by excluding systematic/non-systematic reviews, meta-analysis, practice guidelines, case reports, and study involving animals). The articles assessed for eligibility (n = 160) were primarily evaluated by excluding studies that did not report operative time and conversion to open surgery. For articles that treated multiport LS we included only clinical trials with patients > 20. The studies included in qualitative synthesis were 23. The search strategy carried out in PubMed does not allow to obtain an overview of the items returned by the main queries. With this aim we replicated the search in the Web of Science^TM database, only including the studies published in English in the period 1991-2013 with no other filter/selection criteria. The full records (n = 1141) and cited references returned by Web of Science^TM were analyzed with the visualization of similarities (VOS) mapping technique. Maps of title/abstract text corpus and bibliographic coupling of authors obtained by applying the VOS approach were presented. If in normal-size or moderately enlarged spleens the laparoscopic approach is unquestionable, in massive splenomegaly the optimal technique remain to be determined. In this setting, prospective randomized trials to compare open vs LS are needed. Between the new techniques of LS the robotic single port splenectomy has the ability to join all the positive aspects of both techniques. Data about this topic are too initial and need to be confirmed with further studies.

• Spleen
• Splenectomy
• Laparoscopy
• Minimally Invasive
• Splenic Diseases
• Splenic Neoplasms
• Visualization of similarities mapping

• Adult
• Aged
• Female
• Humans
• Laparoscopy/methods
• Middle Aged
• Pancreatectomy/methods
• Retrospective Studies
• Umbilicus
• Young Adult

AIM: To investigate the feasibility and clinical application of transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments.

METHODS: Between 2010 and 2012, transumbilical single-incision endoscopic splenectomy was performed in 10 patients in our department, of whom 4 had refractory idiopathic thrombocytopenic purpura, 4 had enlarged splenic cyst and 2 had splenic hematoma. A 2.5-cm curved incision was made at the lower umbilicus edge, and a 10 mm laparoscope was inserted into the middle of the incision. A 5-mm harmonic scalpel was placed on the right side, and a 5-mm auxiliary instrument on the left side of the laparoscope. Splenic ligaments were incised with a harmonic scalpel, and the splenic pedicle was cut with an Endo-gastrointestinal anastomosis. The spleen was dissected and placed in a large retrieval bag, blended, and then removed.

RESULTS: All transumbilical single-incision endoscopic splenectomies were performed successfully with mean operative time of 80 ± 5 min and mean blood loss of 150 ± 20 mL. Conversion to laparotomy or multi-port laparoscopic surgery was not required in all cases. All patients were discharged on postoperative days 4-6. During the postoperative hospitalization period, no painkillers were required. No intra-abdominal complications such as infection, ascites, gastric leakage, pancreatic leakage, or wound infection occurred in any case during the 6-mo follow-up.

CONCLUSION: Transumbilical single-incision endoscopic splenectomy using conventional laparoscopic instruments is technically feasible and safe in selected patients.

• Single-incision endoscopic surgery
• Splenectomy
• Transumbilical single-incision endoscopic splenectomy
• Intra-abdominal complications

• Adolescent
• Equipment Design
• Feasibility Studies
• Female
• Humans
• Laparoscopes
• Laparoscopy/adverse effects
• Laparoscopy/instrumentation
• Male
• Retrospective Studies
• Splenectomy/adverse effects
• Splenectomy/instrumentation
• Splenectomy/methods
• Splenic Diseases/diagnosis
• Splenic Diseases/surgery
• Tomography, X-Ray Computed
• Treatment Outcome
• Umbilicus/surgery
• Young Adult

• Anubiscope
• Endoscopic surgical robotic platforms
• Flexible endoscopic surgical platform
• Hepatobiliary surgery
• IsisScope
• LESS
• Laparoendoscopic single-site surgery
• Robotic single-site surgery
• Robotic surgery

• Biliary Tract Surgical Procedures/methods
• Cholecystectomy, Laparoscopic/methods
• Hepatectomy/methods
• Humans
• Laparoscopy/methods
• Liver/surgery
• Pancreas/surgery
• Robotic Surgical Procedures/methods

• Efficacy
• Multiport laparoscopic splenectomy
• Safety
• Single-incision laparoscopic surgery
• Splenectomy
• Systematic review

• Blood Loss, Surgical/statistics & numerical data
• Feasibility Studies
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Length of Stay
• Postoperative Complications/epidemiology
• Splenectomy/adverse effects
• Splenectomy/methods
• Splenectomy/mortality

• pericaudial devascularization
• splenectomy
• transumbilical single-incision laparoscopic surgery

• Humans
• Hypertension, Portal/physiopathology
• Laparoscopy/methods
• Male
• Splenectomy/methods
• Umbilicus/surgery

• Cholecystectomy
• Laparoscopy
• Surgery

• minimally invasive splenic surgery
• new single-site Da Vinci platform
• robotic surgery
• single-incision surgery

Surgery has the potential to remove the entire hydatid cyst and can lead to complete cure. Presence of hydatid cysts in multiple abdominal organs imposes special challenges for laparoscopic management. The patient position and port placement for one organ may not be adequate for other and proper exposure in hydatid cyst is of paramount importance to prevent spillage and complete removal of the cyst. Single incision multi-trocar technique has a unique advantage of allowing surgeon to work in different quadrants of abdomen using the same incision and ports. We report in this paper the first Laparo-endoscopic single-site hepatic cyst excision with partial splenectomy for hydatid cyst in liver and spleen using conventional laparoscopic instruments.

The procedure was performed on a 64 year old female diagnosed to have Hydatid cyst in segment VIII of liver and another cyst in lower pole of spleen a transverse 3 cm incision was made 6 cm above umbilicus and was deepened up to fascia. Two 10mm and one 5mm ports were inserted. Procedure was completed in 160 minutes without any intra-operative complication. There were no post-operative complication and patient was discharged on day 5.

Single incision multi-trocar surgery has cosmetic advantage over standard laparoscopic approach. It is even more marked when two procedures are combined in different quadrants of abdomen. As this is a rare combination procedure so it remains to be determined if this technique offers additional advantages of decreased analgesia, decreased hospital stay or cost effectiveness.

• Hydatid cyst
• hydatid disease of spleen
• partial splenectomy
• single incision multi-trocar surgery
• single incision surgery

• Adult
• Cardia/blood supply
• Cardia/surgery
• Humans
• Hypertension, Portal/surgery
• Laparoscopy/methods
• Male
• Middle Aged
• Retrospective Studies
• Splenectomy/methods
• Umbilicus

• Adult
• Female
• Humans
• Laparoscopy/instrumentation
• Laparoscopy/methods
• Purpura, Thrombocytopenic, Idiopathic/surgery
• Splenectomy/methods

• Adult
• Clinical Competence
• Computer Simulation
• Female
• General Surgery/education
• Humans
• Internship and Residency
• Laparoscopy/education
• Laparoscopy/methods
• Male
• Manikins