Laparoscopic versus robotic subtotal splenectomy in hereditary spherocytosis. Potential advantages and limits of an expensive approach.

Abstract

BACKGROUND:

This study was designed to compare the laparoscopic subtotal splenectomy with the robotic approach in patients with hereditary spherocytosis.

METHODS:

Thirty-two consecutive subtotal splenectomies by minimal approach in patients with hereditary spherocytosis were analyzed (10 robotic vs. 22 laparoscopic subtotal splenectomies).

RESULTS:

A significant difference was found for the robotic approach regarding blood loss, vascular dissection duration, and splenic remnant size. Follow-up for 4-103 months was available.

CONCLUSIONS:

Subtotal splenectomy seems to be a suitable candidate for robotic surgery, requiring a delicate dissection of the splenic vessels and a correct intraoperative evaluation of the splenic remnant. Robotic subtotal splenectomy is comparable to laparoscopy in terms of hospital stay and complication. The main benefits are lower blood loss rate, vascular dissection time, and a better evaluation of the splenic remnant volume.

• Authors: Catalin Vasilescu, Oana Stanciulea, Stefan Tudor
• Journal: Surgical endoscopy (Surg Endosc) Vol. 26 Issue 10 Pg. 2802-9 (Oct 2012) ISSN: 1432-2218 [Electronic] Germany
• PMID: 22476842 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Antibiotic Prophylaxis
• Child
• Child, Preschool
• Cholecystectomy, Laparoscopic (methods)
• Cost Control
• Female
• Gallstones (complications, surgery)
• Humans
• Laparoscopy (economics, methods)
• Length of Stay (economics)
• Male
• Retrospective Studies
• Robotics (economics, methods)
• Spherocytosis, Hereditary (surgery)
• Spleen (diagnostic imaging)
• Splenectomy (education, methods)
• Splenic Diseases (complications, surgery)
• Ultrasonography
• Young Adult