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Single Port Access (SPA) Splenectomy

机译:单端口接入(SPA)脾切除术

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Introduction: Over the last decade, laparoscopic splenectomy has become the standard of care for spleen removal. Elimination of a large incision and difficult exposure has decreased postoperative morbidity and length of stay. Single port access (SPA) surgery was developed as an alternative to traditional multiport laparoscopy, potentially exploiting the already proven benefits of minimally invasive surgery. We apply the SPA technique to splenectomy via a single umbilical incision. Methods: SPA splenectomy was performed in a 36-year-old male for staging. The single-port access technique was used to gain abdominal entry. Exposure, dissection, and removal were performed via a single incision within the umbilicus. The final incision was extended for removal of a complete specimen for pathologic evaluation. Results: Splenic mobilization and control of the short gastrics was successfully performed via a single umbilical incision. The final incision was extended inferiorly for en bloc organ removal. Follow-up at 18 months revealed a well-healed incision with no signs of hernia formation. Conclusions: The single-port access technique has been successfully applied to splenectomy as an available alternative to multiport laparoscopic splenectomy. Use of standard instrumentation and trocars maintains costs and familiarity of the procedure. Exposure, visualization, and dissection are the same as in standard laparoscopy. SPA surgery may be more ergonomically pleasing to the surgeon and offer patient benefits, such as faster recovery and decreased adhesion formation in the long term.
机译:简介:在过去的十年中,腹腔镜脾切除术已成为切除脾脏的标准治疗方法。消除了大切口和困难的暴露,降低了术后发病率和住院时间。单端口接入(SPA)手术是替代传统多端口腹腔镜手术的一种,潜在地利用了微创手术已被证实的优势。我们通过单个脐带切口将SPA技术应用于脾切除术。方法:对36岁的男性进行SPA脾切除术。单端口进入技术用于获得腹部进入。通过脐带内的单个切口进行暴露,解剖和去除。扩大最终切口以取出完整的标本进行病理评估。结果:通过单个脐带切口成功完成了脾脏动员和胃短部控制。最终切口向下延伸以去除整个器官。 18个月的随访显示切口愈合良好,没有疝气形成的迹象。结论:单端口通路技术已成功地应用于脾切除术,作为多端口腹腔镜脾切除术的可用替代方法。使用标准的仪器和套管针可保持成本和对手术过程的熟悉度。曝光,可视化和解剖与标准腹腔镜检查相同。 SPA手术可能更符合人机工程学,并为患者带来好处,例如从长远来看,恢复速度更快,粘连形成减少。

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