Robotic partial resection in patients with cystic neoplasms of the spleen

Introduction. Splenic cysts often require surgical intervention to prevent complications such as rupture or infection of the cyst. The traditional method of treating patients is splenectomy, but given the associated risks, such as overwhelming postsplenectomy sepsis, infectious and thrombotic complications, partial spleen resection has been introduced into clinical practice. Given the rapid development of minimally invasive surgery, it has become possible to perform this intervention using laparoscopic and robot-assisted technologies. However, the experience of performing robot-assisted partial spleen resection (RPSR) in world practice is extremely limited, therefore, it is impossible to conduct evidence-based comparative studies of this surgical technique.
Materials and methods of research. From 2023 to 2025, seven patients (4 men, 3 women; average age 43,1 years) in the surgical clinic of the S.P. Botkina underwent RPSR for benign cystic lesions of the spleen. Preoperative vaccination (pneumococcal, meningococcal and hemophilic type B) was performed one month before the surgery. Based on the anamnesis, clinical picture and data obtained during imaging, hydatid cysts were diagnosed in 3 patients, in 4 cases the neoplasms were assessed as epithelial simple cysts of the spleen. All patients were indicated for surgical intervention, taking into account the etiology of the neoplasm, size or rapid growth. Surgery time, blood loss, postoperative complications and length of hospital stay were recorded for statistical analysis.
Treatment results. All seven robotic-assisted partial spleen resections were successfully performed without cases of conversion to open surgery. The mean procedure time was 136 minutes (range 78–210 min) excluding robotic docking, mean blood loss was 78,6 ml (range 20–150 ml). No serious complications (Clavien-Dindo II–V) were observed in any case. One patient with a cyst 8,6 cm in diameter developed a postoperative wound seroma. The mean hospital stay was 3,6 days (range 3–5 days). During the follow-up, no postoperative infectious and thrombotic complications, splenic infarctions and pancreatic fistulas were observed.
Conclusion. Robot-assisted partial spleen resection is a safe and effective alternative to laparoscopic surgery. The advantages of the robotic system minimize the risk of intra- and postoperative complications, as well as rapid patient recovery after the procedure. Further studies are needed to compare resection methods and optimize surgical approaches.

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