Natural orifice transumbilical versus conventional incision laparoscopic splenectomy: a comparative study

Objective To study the feasibility, safety, operative skills and clinical advantage of natural orifice transumbilical laparoscopic splenectomy. Methods The clinical data of patients who underwent natural orifice transumbilical laparoscopic splenectomy (group A, n=9) and conventional laparoscopic splenectomy (group B, n=15) in our department from Nov. 2011 to Nov. 2014 were reviewed. The operative time, estimated blood loss, post-operation complications, hospital stay, incision satisfaction score and total cost were compared between two groups. Patients with immune thrombocytopenia, presume hereditary splecocytosis and idiopathic hypersplenism were included. Results All the procedures were successfully carried out laparoscopically. The estimated blood loss and total cost showed no significant differences between group A and group B [(196.7±118.7) ml vs (188.7±110.8) ml; (3.7±0.5) vs (3.6±0.7)×104 yuan, P>0.05]. As to the incision satisfaction score, group A was superior to group B [(4.1±0.6) vs (3.4±0.7), P<0.05]. The operation time of group A was significantly longer than that of group B [(201.7±43.2) min vs (131.0±37.1) min, P<0.05]. Conclusion Natural orifice transumbilical laparoscopic splenectomy is a safe and feasible procedure with better satisfactory clinical outcomes than conventional laparoscopic splenectomy. Key words: Laparoscopic splenectomy, transumbilical, concealed approach, conventional approach