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Case Reports
. 2025 May 27:58:101193.
doi: 10.1016/j.tcr.2025.101193. eCollection 2025 Aug.

Robotic assisted splenectomy after failure of splenic angioembolization in blunt abdominal trauma

Zach Rollins  1 , Deki Tsering  1 , Anthony Mark  2 , Terral Goode  2
Affiliations
Case Reports

Robotic assisted splenectomy after failure of splenic angioembolization in blunt abdominal trauma

Zach Rollins et al. Trauma Case Rep. .

Abstract

Traumatic blunt splenic injury in the hemodynamically stable patient is initially managed with a nonoperative strategy that may include angioembolization. If patients continue to have ongoing signs of bleeding after angioembolization, definitive management is surgical splenectomy. We report the case of a patient with a grade IV blunt splenic injury who had ongoing bleeding after angioembolization and was taken for diagnostic robotic surgery. An isolated splenic injury was identified and the patient was treated with robotic splenectomy. On one month follow up the patient was noted to be doing well with minimal pain. To our knowledge, this is the first report of robotic splenectomy after failed non-operative manage in the setting of trauma. This case shows the potential value of robotic surgery to apply the benefits of minimally invasive surgery in hemodynamically stable patients who fail non-operative management after traumatic splenic injury.

Keywords: Blunt trauma; Robotic exploration; Robotic splenectomy; Robotic surgery in trauma; Robotic-assisted exploratory laparoscopy; Splenic embolization; Trauma splenectomy.

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Conflict of interest statement

The authors declare that they have no known competing financial interest of personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Coronal image of splenic capsular hematoma and active extravasation of contrast into the hematoma as shown by the arrow.
Fig. 2
Fig. 2
Port placement. Port 1 is the force bipolar, port 2 is the camera, port 3 is the vessel sealer extended tip, port 4 is the robotic suction, and port 5 is an assist port. The X represents the incision for the Nathanson retractor [18].
Fig. 3
Fig. 3
Accessing the lesser sac. Free fluid and blood can be noted in the lesser sac.
Fig. 4
Fig. 4
Initial visualization of splenic injury with posterior capsule disruption and hematoma.
Fig. 5
Fig. 5
Hemoperitoneum extending from the splenic hilum with ongoing bleeding despite prior embolization.
Fig. 6
Fig. 6
Retraction of the spleen and release of the gastrosplenic attachments.
Fig. 7
Fig. 7
Placement of Everest (J&J MedTech, Warsaw, IN) into splenic fossa after obtaining hemostasis.
See this image and copyright information in PMC

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