title: Robotic splenectomy for mesothelial cyst: a case report.
abstract: Cystic lesions of the spleen represent a rare entity with an overall incidence of 0.5% among splenectomies. They can remain asymptomatic in 30% to 60% of patients or may cause symptoms for secondary compression of adjacent structures. Peripheral cysts may be suitable for conservative treatment whereas splenectomy is the accepted procedure for bulky and/or central lesions. Laparoscopy is the standard approach for elective splenic surgery, but in the last decade, introduction of the da Vinci robotic system has represented a further improvement in minimally invasive surgery, thanks to 3-dimensional vision and more accurate motion control. Herein, we report a case of a mesothelial splenic cysts successfully treated by robotic splenectomy; some anatomical considerations and technical aspects of robotic procedures have been discussed: it is a feasible and safe approach, particularly indicated in the presence of anatomic features such as an enlarged pancreatic tail and a type II vascular pattern of splenic pedicle. In such patients, the choice of a robotic approach may decrease the risk of intraoperative bleeding, thereby representing a further improvement in laparoscopic techniques.
authors.affiliation: U.O.C. Chirurgia Generale 2a, Centro di Chirurgia Mininvasiva e Robotica, Azienda Ospedaliera San Giovanni-Addolorata, Rome, Italy. giorgiolucandri@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lucandri
authors.forename: Francesco
authors.initials: F
authors.lastname: Felicioni
authors.forename: Igor
authors.initials: I
authors.lastname: Monsellato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Alfano
authors.forename: Graziano
authors.initials: G
authors.lastname: Pernazza
authors.forename: Vito
authors.initials: V
authors.lastname: Pende
authors.forename: Paolo
authors.initials: P
authors.lastname: Mazzocchi
authors.forename: Bruno
authors.initials: B
authors.lastname: Bascone
authors.forename: Annibale
authors.initials: A
authors.lastname: D'Annibale
mesh_terms: D000328:Adult; D003560:Cysts / Q000473:pathology / Q000601:surgery*; D004848:Epithelium / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics / Q000379:methods*; D013154:Spleen / Q000473:pathology / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D013160:Splenic Neoplasms / Q000473:pathology / Q000601:surgery*