Laparoscopic splenectomy: Evolution and current status

The aim of this review is to assess the indications for, and surgical appro ach to, laparoscopic splenectomy (LS) and to propose a recommendation for t he surgical approach to LS. The reports of LS were reviewed with a detailed analysis of indications, surgical technique, and clinical outcome. Thirty- two articles including a total of 643 patients (549 adults and 94 children) were published between August 1994 and May 1997, with a mean of 20 cases p er report. LS is recommended if the spleen has a maximum diameter of 20 cm. Compared to the open procedure, there are fewer perioperative complication s, less morbidity, and a shorter hospital stay. The disadvantages of LS are longer operation times and less sensitivity in identifying accessory splee ns. LS is not the operation of choice for hypersplenism and traumatic splen ic injury.