Laparoscopic splenectomy: 3 ports are enough.

With advanced technologies and accumulating experience, a new consensus concerning the least invasive laparoscopic splenectomy should be addressed. We retrospectively analyzed 41 consecutive patients who underwent laparoscopic splenectomy from 1994 to 2007. We divided our patients into 3 groups according to the number of trocars used: group 1 (n=11, 5 trocars), group 2 (n=21, 4 trocars), and group 3 (n=9, 3 trocars). In each group, postural change was made for the operation: supine for group 1, semilateral for group 2, and true lateral for group 3. Except for the shorter operation time for group 3 compared with group 1 and group 2 (P<0.001), there were no differences in perioperative parameters. Considering the least invasive nature of laparoscopic operations, 3-port splenectomy seems to be very promising in this context. Additionally, proper modification of patient's posture is an essential part of the least invasive ever 3-port laparoscopic splenectomy.