Robotic-Assisted Splenectomy by a Modified Lateral Approach: Technique and Outcomes

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robot-assisted surgery is increasingly adopted for splenectomy, particularly for hematological indications.
• Its benefits include enhanced visualization and instrument maneuverability within the abdominal cavity.
• It serves as a valuable training module for complex robotic procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of a modified lateral approach for robot-assisted splenectomy.
• To compare outcomes of robotic splenectomy with conventional methods for hematological indications.

Main Methods:

• Retrospective analysis of prospectively maintained data from 43 elective splenectomies for hematological indications.
• 14 patients underwent robotic splenectomy using a modified lateral approach, avoiding lesser sac dissection.
• Data collected included operative time, blood loss, transfusion requirements, and postoperative morbidity/mortality.

Main Results:

• Indications included idiopathic thrombocytopenic purpura, autoimmune hemolytic anemia, Evans syndrome, and hereditary spherocytosis.
• The median splenic diameter was 14.8cm; median pre-operative platelet count was 10,800/mm³.
• Mean operative time was 92 minutes, with 40ml blood loss. Median hospital stay was 2.4 days. No mortality or morbidity occurred.

Conclusions:

• Robot-assisted splenectomy with the modified lateral approach is safe and feasible.
• Outcomes regarding operative time, blood loss, and morbidity are comparable to existing techniques.
• Further research is needed to confirm the specific advantages of this modified lateral approach.