Published online Sep 16, 2017. doi: 10.4253/wjge.v9.i9.428
Peer-review started: February 10, 2017
First decision: May 10, 2017
Revised: May 21, 2017
Accepted: July 21, 2017
Article in press: July 24, 2017
Published online: September 16, 2017
Since early 1990’s, when it was inaugurally introduced, laparoscopic splenectomy has been performed with excellent results in terms of intraoperative and postoperative complications. Nowadays laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen. However some contraindications still apply. The evolution of the technology has allowed though, cases which were considered to be absolute contraindications for performing a minimal invasive procedure to be treated with modified laparoscopic approaches. Moreover, the introduction of advanced laparoscopic tools for ligation resulted in less intraoperative complications. Today, laparoscopic splenectomy is considered safe, with better outcomes in comparison to open splenectomy, and the increased experience of surgeons allows operative times comparable to those of an open splenectomy. In this review we discuss the indications and the contraindications of laparoscopic splenectomy. Moreover we analyze the standard and modified surgical approaches, and we evaluate the short-term and long-term outcomes.
Core tip: With the advent of laparoscopic techniques, laparoscopic splenectomy has become the procedure of choice for benign and malignant diseases of the spleen. Splenomegaly can be alternatively treated with modified hand-assisted approach. In addition the introduction of advanced laparoscopic tools for ligation and electrocauterization contributed to reduced blood loss at surgery and minimal morbidity.