Preliminary experience of sandwich repair technique: A new method of laparoscopic splenorraphy for high-grade splenic injuries
Journal
Surgical Innovation
Journal Volume
21
Journal Issue
4
Pages
355-364
Date Issued
2014
Author(s)
Abstract
Background. Laparoscopic splenectomy has been used safely for patients with blunt splenic trauma and failed nonoperative management. Reports of using laparoscopic splenorraphy for spleen salvage were fewer and mainly limited to lower grades of injuries. No study has focused on the role of laparoscopic splenorraphy in the treatment of patients with high grades of splenic injuries. Methods. Medical records of 15 patients with high grades of splenic injuries that required an operation for failed nonoperative management were retrospectively reviewed. They underwent a new technique of sandwich repair laparoscopically for spleen salvage by 3 surgeons who had adequate training in laparoscopy for trauma. Preoperative parameters, sandwich repair technique, perioperative parameters, and postoperative outcomes were evaluated. Results. Fourteen of the 15 (93.3%) patients underwent the technique successfully with 1 patient converting to laparotomy. The median (interquartile range) time to reach hemostasis was 30.0 (26.0-40.0) minutes, and the median overall operation time was 135.0 (120.0-165.0) minutes. Median blood loss amount was 1300.0 (750.0-2300.0) mL. The median length of hospital stay was 8.0 (7.0-11.0) days, and the intensive care unit stay was 2.0 (0.0-4.0) days. No mortality was noted. No rebleeding, total splenic infarction, or intra-abdominal abscess was noted during 3-month follow-up after the operation. Conclusions. The preliminary results show that laparoscopic splenorraphy by the "sandwich repair technique" is feasible and safe for patients with high-grade splenic injuries. ? 2013 The Author(s).
SDGs
Other Subjects
abdominal abscess; abdominal blunt trauma; adult; article; bleeding; clinical article; female; follow up; hemostasis; hospitalization; human; intensive care unit; laparoscopic splenorraphy; laparoscopic surgery; laparotomy; male; mortality; operation duration; patient safety; perioperative period; postoperative period; retrospective study; sandwich repair technique; spleen infarction; spleen injury; spleen surgery; surgical technique; thorax drainage; training; Abdominal Injuries; adverse effects; cohort analysis; computer assisted tomography; conversion to open surgery; evaluation study; injuries; injury scale; laparoscopy; length of stay; operative blood loss; pathophysiology; procedures; radiography; risk assessment; spleen; splenectomy; statistics and numerical data; treatment outcome; Abdominal Injuries; Blood Loss, Surgical; Cohort Studies; Conversion to Open Surgery; Female; Follow-Up Studies; Humans; Injury Severity Score; Laparoscopy; Laparotomy; Length of Stay; Male; Operative Time; Patient Safety; Retrospective Studies; Risk Assessment; Spleen; Splenectomy; Tomography, X-Ray Computed; Treatment Outcome
Type
journal article