{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T17:57:15Z","timestamp":1773597435005,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2002,8,1]],"date-time":"2002-08-01T00:00:00Z","timestamp":1028160000000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2002,7]]},"abstract":"<jats:p><jats:bold>Background:\u2003<\/jats:bold> To document the technical aspects, outcome and lessons learnt during the learning curve phase of implementing laparoscopic splenectomy, by comparing the results before and after the introduction of a standardized technique.<\/jats:p><jats:p><jats:bold>Methods:\u2003<\/jats:bold> We present a retrospective and prospective review of laparoscopic splenectomies over a 4\u2010year period. Two chronological periods were studied, before and after the implementation of a standardized technique of a laparoscopic splenectomy involving: (i) hilar dissection with ultrasonic shears; (ii) two experienced laparoscopic surgeons; and (iii) trained dedicated equipment and staff using a checklist approach in the preparation and conduct of the operation. Two groups of patients were studied relating to the periods before and after the implementation of a standardized technique. Statistical methods used were the Wilcoxon's rank sum test and the two\u2010sample test.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> Thirty\u2010one laparoscopic splenectomies were attempted. The most common indication was for idiopathic thrombocytopenic purpura. When comparing the early phase (<jats:italic>n<\/jats:italic>\u2003=\u200315) with the standardized technique phase (<jats:italic>n<\/jats:italic>\u2003=\u200316), there was a significant reduction in conversion rates (40% <jats:italic>vs<\/jats:italic> 6%), operating times (218\u2003min <jats:italic>vs<\/jats:italic> 171\u2003min), complication rates (6 cases including 1 death <jats:italic>vs<\/jats:italic> none) and length of stay (11\u2003days <jats:italic>vs<\/jats:italic> 4\u2003days). The results were significant for reduction in hospital stay, conversion rates and complications rates.<\/jats:p><jats:p><jats:bold>Conclusions:\u2003<\/jats:bold> A reduction in conversion rates, operating time, morbidity and length of stay was realized during the learning curve of implementing laparoscopic splenectomy by adopting a standardized technique. This technique involved hilar dissection using the ultrasonic shears, two experienced laparoscopic surgeons performing the surgery, dedicated equipment and trained staff using the checklist approach. We recommend such a standardized technique in performing laparoscopic splenectomy.<\/jats:p>","DOI":"10.1046\/j.1445-2197.2002.02461.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T02:50:05Z","timestamp":1047351005000},"page":"523-527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Technical developments and a team approach leads to an improved outcome: Lessons learnt implementing laparoscopic splenectomy"],"prefix":"10.1111","volume":"72","author":[{"given":"Sorway W.","family":"Chan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Hensman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce P.","family":"Waxman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Blamey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Cox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Farrell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Fox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gribbin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laront","family":"Layani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,8]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(96)80085-7"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(96)00386-8"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(96)00241-3"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1007\/s004649900221","article-title":"Laparoscopic splenectomy for ITP","volume":"10","author":"Friedman RL","year":"1996","journal-title":"Surg. 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