Related Experiment Video
Updated: Oct 31, 2025
Robotic Spleen-Preserving Distal Pancreatectomy: The Warshaw and Kimura Techniques
Published on: July 26, 2024
Robotic versus Laparoscopic Surgery for Spleen-Preserving Distal Pancreatectomies: Systematic Review and
Gianluca Rompianesi1, Roberto Montalti1, Luisa Ambrosio1
1Division of Hepato-Bilio-Pancreatic, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S.Pansini 5, 80131 Naples, Italy.
Background:
When oncologically feasible, avoiding unnecessary splenectomies prevents patients who are undergoing distal pancreatectomy (DP) from facing significant thromboembolic and infective risks.
Methods:
A systematic search of MEDLINE, Embase, and Web Of Science identified 11 studies reporting outcomes of 323 patients undergoing intended spleen-preserving minimally invasive robotic DP (SP-RADP) and 362 laparoscopic DP (SP-LADP) in order to compare the spleen preservation rates of the two techniques. The risk of bias was evaluated according to the Newcastle-Ottawa Scale.
Results:
SP-RADP showed superior results over the laparoscopic approach, with an inferior spleen preservation failure risk difference (RD) of 0.24 (95% CI 0.15, 0.33), reduced open conversion rate (RD of -0.05 (95% CI -0.09, -0.01)), reduced blood loss (mean difference of -138 mL (95% CI -205, -71)), and mean difference in hospital length of stay of -1.5 days (95% CI -2.8, -0.2), with similar operative time, clinically relevant postoperative pancreatic fistula (ISGPS grade B/C), and Clavien-Dindo grade ≥3 postoperative complications.
Conclusion:
Both SP-RADP and SP-LADP proved to be safe and effective procedures, with minimal perioperative mortality and low postoperative morbidity. The robotic approach proved to be superior to the laparoscopic approach in terms of spleen preservation rate, intraoperative blood loss, and hospital length of stay.
