Contained morcellation of the spleen using a completely enclosed laparoscopic isolation system: a 5-year follow-up study on the evaluation of splenosis.

BACKGROUND: Specimen extraction in massive splenomegaly remains a major challenge in laparoscopic splenectomy. To address this, the Completely Enclosed Laparoscopic Isolation System (CELIS) was utilized to enable contained morcellation without incision enlargement. METHODS: This single-arm retrospective study included 14 patients undergoing CELIS-assisted laparoscopic splenectomy with fully enclosed morcellation under intrabag pneumoperitoneum. RESULTS: All procedures were completed without conversion or incision enlargement. Mean operative time was 182.86 ± 52.84 min, with efficient CELIS deployment and morcellation. Postoperative pain was low (VAS 2.64 on day 1), and cosmetic outcomes were favorable. Within this small, single-arm retrospective cohort (n = 14), 0/14 cases of clinically or radiologically detectable splenosis or ectopic splenic implantation were observed during the 5-year follow-up (95% CI: 0.0%-23.2%), suggesting the preliminary safety and feasibility of this technique. CONCLUSIONS: This preliminary study suggests that CELIS-assisted contained morcellation is technically feasible for large to massive spleens. The 5-year follow-up provides preliminary observational data regarding the absence of detectable splenosis in this selected cohort, though larger comparative studies are required.