Steep learning curve of laparoscopic splenectomy

Bagdasarian, Rainer W., Bolton, John S., Bowen, John C., Fuhrman, George M. and Richardson, William S. (2000) Steep learning curve of laparoscopic splenectomy. Journal of Laparoendoscopic and Advanced Surgical Techniques Parts A, 10 6: 319-323. doi:10.1089/lap.2000.10.319

Author Bagdasarian, Rainer W.
Bolton, John S.
Bowen, John C.
Fuhrman, George M.
Richardson, William S.
Title Steep learning curve of laparoscopic splenectomy
Journal name Journal of Laparoendoscopic and Advanced Surgical Techniques Parts A   Check publisher's open access policy
ISSN 1092-6429
Publication date 2000-12
Sub-type Article (original research)
DOI 10.1089/lap.2000.10.319
Volume 10
Issue 6
Start page 319
End page 323
Total pages 5
Place of publication New Rochelle, NY, United States
Publisher Mary Ann Liebert
Language eng
Formatted abstract
Background and Purpose:
In 1992, Ochsner Foundation Hospital was among the first institutions in which laparoscopic splenectomy was performed. The aim of this study is to review our experience and discuss the lessons learned.

A retrospective review of 33 cases of laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP) (N = 22), autoimmune hemolytic anemia (AIHA) (5), thrombocytopenic purpura (TTP) (2), and other disorders (4) at Ochsner Foundation Hospital between 1992 and 1999 was conducted. Several measures, including rates of conversion to open splenectomy, were recorded and analyzed.

Of the 33 cases, 26 (79%) were completed laparoscopically. Four were converted to an open procedure secondary to bleeding and three secondary to difficulty in dissection. Six conversions to open surgery were necessary during the first eight laparoscopic splenectomies and only one during our last 25 cases. Two patients required reoperations for bleeding. The average hospital stay after laparoscopic splenectomy was 2.3 days; eight patients stayed only 1 day. All of the TTP patients, 86% of the patients with ITP, and 40% of those with AIHA responded well to splenectomy.

Laparoscopic splenectomy is a safe although complex procedure. Bleeding is the major complication but has been less common with experience. Even with today's technology, very large spleens are still extremely difficult to remove. With the short recovery and ready acceptance of patients and physicians, this technique is being used with increasing frequency. A significant learning curve exists for the safe completion of this challenging procedure.
Keyword Immune therombocytopenic purrura
Hematologic disease
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:48:56 EST