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Updated: Jul 11, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Laparoscopic splenic procedures in children: experience in 231 children
Frederick J Rescorla1, Karen W West, Scott A Engum
1Department of Surgery, Section of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA. frescorl@iupui.edu
Insights
Laparoscopic splenic procedures are safe and effective for children, with a low complication rate and short hospital stays. Laparoscopic splenectomy is the preferred surgical option for most pediatric splenic conditions.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic splenic procedures offer a minimally invasive approach for various pediatric splenic conditions.
- Evaluating the safety and efficacy of these procedures is crucial for establishing best practices.
Purpose of the Study:
- To assess the effectiveness and complication rates of laparoscopic splenic procedures in pediatric patients.
- To determine if laparoscopic splenectomy is a suitable alternative to open surgery.
Main Methods:
- A prospective database review of 231 children (1995-2006) undergoing laparoscopic splenic procedures.
- Analysis of indications, operative details, conversion rates, complications, and length of stay.
Main Results:
- Laparoscopic splenectomy was performed in 223 children (total: 211, partial: 12) for conditions including hereditary spherocytosis, immune thrombocytopenic purpura, and sickle cell disease (SCD).
- Eight additional procedures included splenic cystectomy and splenopexy. Overall complication rate was 11%, higher in SCD patients (22%).
- No deaths, wound infections, or pancreatitis occurred. Average length of stay was 1.5 days.
Conclusions:
- Laparoscopic splenic procedures are safe and effective in children, demonstrating low morbidity and mortality.
- The study highlights a higher complication rate in SCD patients and a low conversion rate to open surgery.
- Laparoscopic splenectomy is established as the preferred surgical method for most pediatric splenic interventions.
Objectives:
The purpose of this report is to evaluate the efficacy of and complications observed after laparoscopic splenic procedures in children.
Methods:
Review of a prospective database at a single institution (1995-2006) identified 231 children (129 boys; 102 girls; average age 7.69 years) undergoing laparoscopic splenic procedures.
Results:
Two hundred twenty-three children underwent laparoscopic splenectomy (211 total; 12 partial) by the lateral approach. Indication for splenectomy was hereditary spherocytosis (111), immune thrombocytopenic purpura (36), sickle cell disease (SCD) (51), and other (25). Four (2%) required conversion to an open procedure. Eight additional laparoscopic splenic procedures were performed: splenic cystectomy for epithelial (4) or traumatic (2) cyst, and splenopexy for wandering spleen (2). Average length of stay was 1.5 days. Complications (11% overall, 22% in SCD patients) included ileus (5), bleeding (4), acute chest syndrome (5), pneumonia (2), portal vein thrombosis (1), priapism (1), hemolytic uremic syndrome (1), diaphragm perforation (2), colonic injury (1), missed accessory spleen (1), trocar site hernia (1), subsequent total splenectomy after an initial partial (1), and recurrent cyst (1). Subsequent operations were open in 3 (colon repair, hernia, and missed accessory spleen) and laparoscopic in 2 (completion splenectomy, and cyst excision). There were no deaths, wound infections, or instances of pancreatitis.
Conclusions:
Laparoscopic splenic procedures are safe and effective in children and are associated with low morbidity, higher complication rate in SCD, low conversion rate, zero mortality, and short length of stay. Laparoscopic splenectomy has become the procedure of choice for most children requiring a splenic procedure.
