Laparoscopic Adrenalectomy and Splenectomy Are Safe and Reduce Hospital Stay and Charges

Heslin, Martin J.; Winzeler, Ashley H.; Weingarten, Jill O.; Diethelm, Arnold G.; Urist, Marshall M.; Bland, Kirby I.
May 2003
American Surgeon;May2003, Vol. 69 Issue 5, p377
Academic Journal
The proposed benefits of laparoscopy for certain surgical procedures have been decreased postoperative pain and hospital stay balanced against the proposed deficits of increased costs. We have reviewed our data to evaluate factors associated with patient, procedure, and hospital charges for patients undergoing open versus laparoscopic adrenalectomy and splenectomy during the same time period. Eighty-seven patients underwent adrenalectomy (n = 47) or splenectomy (n = 40) from October 30, 1995 to June 6, 2001 and were retrospectively reviewed. Patient and operative factors were analyzed by intent to treat; the major endpoints were operating room (OR) time in minutes, blood loss in cm³, length of hospital stay in days, and charges broken down by anesthesia/operation [OR/recovery room (RR)] and total charges in dollars x 1000. Comparisons of means were analyzed by unpaired t test; data are presented as mean ± SEM, and significance is defined as P < 0.05. Median age of the group was 47 years (range 20-77). Forty-five patients underwent a laparoscopic approach of which two were converted to open (4%) as compared with 42 undergoing an open operation; one patient from each group was excluded from outcome analyses because of prolonged hospitalization (>3 weeks). Operative mortality of the whole group was one per cent. There were no differences between the groups with respect to age, gender, or comorbidity. The laparoscopic group had significantly longer operative times and OR/RR charges. However, the length of hospital stay and the total charges for the patient undergoing a laparoscopic approach were significantly less (P < 0.05). We conclude that a laparoscopic approach for adrenalectomy or splenectomy can be accomplished in approximately 95 per cent of patients selected for this procedure. Despite prolonged OR time and increased OR/RR charges the laparoscopic procedures resulted in significantly decreased length of hospital stay and overall patient...


Related Articles

  • Laparoscopic Splenectomy with the da Vinci Robot. Bodner, Johannes; Lucciarini, Paolo; Fish, John; Kafka-Ritsch, Reinhold; Schmid, Thomas // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2005, Vol. 15 Issue 1, p1 

    Background: We report our first series of minimally invasive splenectomies with a robotic surgical system. Methods: From August 2001 to October 2003, laparoscopic splenectomies with the da Vinci® operating robot were performed in 7 patients (five females and two males, ages 20 to 74 years)....

  • Beyond splenectomy -- options for the management of splenic trauma. Whitfield, C.G.; Garner, J.P. // Trauma;Oct2008, Vol. 10 Issue 4, p247 

    The spleen remains a vulnerable organ to blunt or penetrating abdominal trauma and recognition of its important immunological role has meant that alternatives to mandatory splenectomy for splenic injury are now available. This article examines the alternatives to splenectomy and then discusses...

  • Indications for Splenectomy. Katz, Steven C.; Pachter, H. leon // American Surgeon;Jul2006, Vol. 72 Issue 7, p565 

    In the new millennium, indications for splenectomy have expanded. Proper patient selection based on an understanding of the biology of each individual's disease is essential for a favorable outcome. We review the most common diseases for which surgeons may be called on to perform splenectomy and...

  • splenectomy. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p708 

    An encyclopedia entry for "splenectomy" is presented. It refers to the surgical removal of the spleen. The procedure is performed after the spleen has been seriously injured or to treat hypersplenism. Individuals who have had a splenectomy are more susceptible to certain infections and are given...

  • The role of laparoscopic adrenalectomy for adrenal tumours of 6 cm or greater. Parnaby, C. N.; Chong, P. S.; Chisholm, L.; Farrow, J.; Connell, J. M.; O'Dwyer, P. J. // Surgical Endoscopy;Mar2008, Vol. 22 Issue 3, p617 

    Laparoscopic adrenalectomy (LA) has been shown to reduce hospital stay and morbidity when compared to open adrenalectomy (OA). It is uncertain if the laparoscopic resection of large (≥6 cm) potentially malignant adrenal tumours is appropriate due to concern over incomplete resection and...

  • Partial versus Total Adrenalectomy by the Posterior Retroperitoneoscopic Approach: Early and Long-term Results of 325 Consecutive Procedures in Primary Adrenal Neoplasias. Walz, Martin K.; Peitgen, Klaus; Diesing, Daniela; Petersenn, Stephan; Janssen, Onno E.; Philipp, Thomas; Metz, Klaus A.; Mann, Klaus; Schmid, Kurt W.; Neumann, Hartmut P. H. // World Journal of Surgery;Dec2004, Vol. 28 Issue 12, p1323 

    The retroperitoneoscopic approach is a standardized operative procedure for primary adrenal gland tumors. It allows direct access with a detailed view of the adrenal gland. Thereby, a clear differentiation between normal and neoplastic adrenal tissue is often possible, which permits a planned...

  • Laparoscopic Splenectomy for Hematologic Disorders: Experience with the First Fifty Patients. Chowbey, Pradeep K.; Goel, Amit; Panse, Rashmi; Sharma, Anil; Khullar, Rajesh; Soni, Vandana; Baijal, Manish // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2005, Vol. 15 Issue 1, p28 

    Background: Splenectomy is increasingly being performed by various minimal access surgical modaliities for select hematologic disorders. Methods: A retrospective analysis was performed on the first 50 patients on whom laparoscopic splenectomy (LS) was attempted. The data studied included...

  • BLEEDING ESOPHAGEAL VARICES IN MYELOFIBROSIS. Dagradi, Angelo E.; Siemsen, Jan; Brook, Jack; Stempien, S. J. // American Journal of Gastroenterology;Dec1965, Vol. 44 Issue 6, p536 

    Presents a case study of performing splenectomy with splenorenal shunt to elucidate further the etiology of portal hypertension resulting from bleeding esophageal varices in myelofibrosis. Case history; Laboratory studies; Course in hospital.

  • Preventing severe infection after splenectomy. Newland, Adrian; Provan, Drew; Myint, Steven // BMJ: British Medical Journal (International Edition);8/20/2005, Vol. 331 Issue 7514, p417 

    Reports that a splenectomy procedure may be followed by severe systemic infection because such surgery removes the splenic marophages that filter and phagocytose bacteria and other bloodborne pathogens. Discussion of how post-splenectomy infection (OPSI) is uncommon but has a high mortality...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics