Single-incision laparoscopic splenectomy : an efficient technique for the hilum exposure Takeyuki MISAWA 1 , Nobuhiro TSUTSUI 1 , Taro SAKAMOTO 1 , Ryusuke ITO 1 , Takeshi GOCHO 1 , Katsuhiko YANAGA 1 1Department of Surgery, The Jikei University School of Medicine Keyword: 単孔式手術 , 腹腔鏡下脾臓摘出術 , 脾門挙上法 , 脾動脈瘤 pp.519-524
Published Date 2010/8/15
DOI https://doi.org/10.11477/mf.4426100521
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 In traditional laparoscopic splenectomy using four or more trocars, a hanging of the splenic hilum using a flexible retractor is an effective technique to obtain good exposure of the pancreatic tail and the splenic hilum. However, in single-incision laparoscopic splenectomy, an innovative and challenging procedure, no trocar is available for the hanging of the spleen since the number of trocar is limited. Herein, in single-incision laparoscopic splenectomy, we invented a surgical technique using a cloth tape to hang the splenic hilum through an extra skin needle hole. A 58-year-old woman with a saccular splenic aneurysm, measuring 2.6×15 mm in diameter at the splenic hilum, underwent single-incision laparoscopic splenectomy. During the operation, this new technique provided excellent exposure of the splenic hilum, the pancreatic tail, splenic artery, splenic vein, and aneurysm. Moreover, it facilitated the introduction of a surgical stapler to the splenic hilum. This technique enabled us to perform single-incision laparoscopic splenectomy safely and it may also allow to reduce the number of trocars even in traditional laparoscopic splenectomy.

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