Comparison of two laparoscopic techniques for detecting the accessory spleen: standard versus transumblical multiport single-site laparoscopy

Abstract

Background: Minimally invasive techniques such as Transumbilical Multiport Splenectomy (TUMPS) have begun to take the place of laparoscopy, which is the gold standard for splenectomy. Accessory Spleen (AcS) is an important cause of relapse after surgery for Benign Hematologic Diseases (BHD). We aimed to compare both techniques in the detection of AcS. Methods: 46 patients who underwent either laparoscopic surgery or TUMPS for BHD were included in the study. The perisplenic area, greater omentum, tail of the pancreas, and splenic ligaments were routinely checked for AcS in both techniques in all patients. Results: 27 (59%) patients underwent TUMPS and 19 (41%) underwent laparoscopic splenectomy. Patients were followed up for an average of 42 months. In total, 13 cases of AcS were detected in 11 (23.9%) of the 46 patients. The locations of AcS were the splenic hilum (n=5, 38.4%), the lower pole of the spleen (n=3, 23%), the gastrosplenic ligament (n=2, 15.3%), the omentum majus (n=1, 7.6%), the gastrocolic ligament (n=1, 7.6%) and the tail of the pancreas (n=1, 7.6%). There was no statistically significant difference between the two groups in terms of hospitalisation (p=0.178), operation time (p=0.342), bleeding (p=0.076) and VAS pain score (p=0.718). Conclusion: Exploration using TUMPS by experienced surgeons reveals similar results in the detection of AcS.