Efficacy of endoscopic vascular staplers for splenichilar control during laparoscopic splenectomy

Özet

Introduction: This study aimed to assess the results and effectiveness of using endoscopic vascular sta-plers for splenic hilar control in 36 consecutive cases who underwent elective laparoscopic splenectomy due to hematologic problems.Materials and Methods: Thirty-six consecutive patients who underwent laparoscopic splenectomy (LS) due to hematologic diseases over a 3-year period between January 2012–May 2015 were included in this study. LS was carried out with the standard 4-port method. All hilar vessels were divided by using an en-doscopic stapler loaded with vascular cartridges. Patient demographic data, hematologic diagnosis, size of the spleen, duration of operation, length of hospital stay, post-operative complications, postoperative analgesic requirement were retrospectively extracted from patient files.Results: A total of 36 consecutive patients were treated in a single center and were operated by two sur-geons. There was no conversion to laparotomy or reoperation in the series. One patient developed acute portal vein thrombosis that was medically treated in the early post-operative period. Another patient expe-rienced pneumothorax due to a diaphragmatic injury that was repaired during surgery. The average spleen size was identified as 14.5 cm. An accessory spleen was detected in 5 patients. The mean operative time was 97 minutes, and the mean length of hospital stay was 2.3 days.Conclusion: We believe that using an endoscopic vascular stapler for ligation of hilar vascular structures during elective laparoscopic splenectomy by experienced surgeons is efficient despite the cost disadvan-tage