Robot-assisted treatment of splenic artery aneurysms

Abstract

Background: Although splenic artery aneurysms (SAAs) are relatively uncommon, they are clinically relevant because of the risk of rupture. Optimal management is a matter of debate and involves the use of percutaneous endovascular stenting, which has limitations, versus the open surgical approach which can lead to significant morbidity. The present study reports the outcomes of robot-assisted surgery for SAA and its role in overcoming many of the limitations of laparoscopy.

Methods: A total of nine patients with incidentally detected SAAs underwent a surgery between September 2001 and November 2007. Six of these nine patients underwent a robot-assisted splenic aneurysm resection with vascular reconstruction. The remaining three cases included one robotic arterial ligation, one robotic partial splenectomy, and one laparoscopic splenectomy.

Results: The mean operating time was 212 ± 61 minutes (range: 90-300), mean intraoperative blood loss was 186.6 ± 202.4 mL (range: 0-500), and mean hospital stay was 7.1 ± 3.7 days (range: 3-14). The morbidity rate was 11.1% and no mortality was reported. Doppler-ultrasonography surveillance showed regular organ perfusion in all patients with vascular reconstruction.

Conclusion: Robot-assisted surgery for SAA represents one of the most advanced developments among minimally invasive procedures and can become an important option for the treatment of this disease.