Robotic vs laparoscopic splenectomy for splenomegaly: A retrospective comparative cohort study

Background: The aim of this study was to evaluate the role of robotic total splenectomy for splenomegaly, comparing this approach with the laparoscopic technique. Methods: We conducted a retrospective review of all patients who underwent minimally invasive splenectomy for splenomegaly (maximum splenic diameter > 15 cm) at our institution between 2000 and 2017. Results: A total of 39 patients (27 laparoscopic vs 12 robotic splenectomies) were included in the study. Operative time was significantly longer in the robotic group (270 min vs 180 min, p=0.007). Median intraoperative blood loss was 350 ml for laparoscopic procedures while it was 100 ml for the robotic ones (p=0.032). Conversion to open surgery was required in 4 cases of laparoscopic splenectomy while no conversion were registered in the robotic group. No significant differences were seen in postoperative morbidity and mortality between the two groups. Conclusions: Robotic splenectomy for splenomegaly is associated with less blood loss and longer operative times than the laparoscopic procedure.