Comparison between Laparoscopic Splenectomy Using LigaSure and Open Splenectomy for Non-traumatic Diseases

Abstract

Background and Objective: Laparoscopic splenectomy (LS) has become the standard approach for non-traumatic splenic disorders. Previous studies demonstrated the effectiveness and safety of LigaSure for the dissection and sealing of splenic pedicels in LS. This study compared the efficacy and safety of LS using LigaSure and open splenectomy (OS) in patients with non-traumatic disease.

Materials and Methods: We retrospectively reviewed patients who underwent LS and OS. Operative data, perioperative course, and clinical outcome were assessed.

Results: In all, 25 patients were included in the analysis; 6 in the OS group, and 19 in the LS group. The OS group had a significantly shorter duration of surgery (median [interquartile range; IQR] = 45 [30-95] vs. 100 [60-120] minutes, p=0.030). The LS group had significantly lower post-operative pain scores (median [IQR] = 7 [6-9] vs. 3 [1-5], p<0.001) and shorter time to step diet (median [IQR] = 18 [18 to 24] vs. 6 [6 to 18] h, p=0.003). No mortality occurred in either group. There was no significant difference in perioperative complications between the two groups (16.7% vs. 26.3%, p=0.629).

Conclusion: Laparoscopic splenectomy using LigaSure appeared safe, feasible, and efficacious for non-traumatic splenic disorders. LS using LigaSure was associated with a significantly longer duration of surgery, lesser postoperative pain, and faster resumption of oral diet compared to OS, without increased risks of intraoperative bleeding and perioperative complications.