title: 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.affiliation: Department of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 258 Fundeni Street, Bucharest, Romania. catvasilescu@gmail.com
authors.forename: Catalin
authors.initials: C
authors.lastname: Vasilescu
authors.forename: Oana
authors.initials: O
authors.lastname: Stanciulea
authors.forename: Stefan
authors.initials: S
authors.lastname: Tudor
mesh_terms: D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D003363:Cost Control; D005260:Female; D042882:Gallstones / Q000150:complications / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods*; D007902:Length of Stay / Q000191:economics; D008297:Male; D012189:Retrospective Studies; D012371:Robotics / Q000191:economics* / Q000379:methods*; D013103:Spherocytosis, Hereditary / Q000601:surgery*; D013154:Spleen / Q000000981:diagnostic imaging; D013156:Splenectomy / Q000193:education* / Q000379:methods*; D013158:Splenic Diseases / Q000150:complications / Q000601:surgery; D014463:Ultrasonography; D055815:Young Adult