BACKGROUND
The study presents the first examples of the use of robot-assisted surgery for fenestration (decortication) of the external portion of splenic cysts and argon-plasma coagulation of its internal lining.
MATERIAL AND METHODS
The study presents retrospective data on 2 patients with primary spleen cysts operated on using robot-assisted technology at the Irkutsk State Regional Children’s Clinical Hospital. The diagnosis was established by ultrasound examination of the abdominal cavity, as well as data from multislice computed tomography with intravenous administration of a contrast agent. The surgical procedure was performed using a new model of the Versius robotic system manufactured by CMR Surgical (UK). Most of the cyst wall, which was elevated above the kidney tissue, was excised with a bipolar clamp along the border of the avascular zone to prevent bleeding from the spleen parenchyma, and sent for histological examination. The remaining areas of the epithelial lining of the cyst were subjected to argon-plasma coagulation.
RESULTS
The age of the patients at the time of surgery was 6 and 14 years. The weight of patients at the time of surgery was 21 and 47.5 kg. The size of the cysts was 6 and 8 cm. Cystic formations in all patients were located in the upper pole. The total duration of the operation was 40 and 65 minutes. Of these, 10 and 15 minutes were spent on the installation of the robot. The pure time of the robotic procedure, excluding the installation of the robot, was 30 and 50 minutes. During the surgical intervention, there were no complications in the form of bleeding from the spleen parenchyma or damage to neighboring organs. Histological analysis revealed that the lining of the cyst wall contained lymphatic epithelium without signs of malignancy. The duration of stay of patients in the intensive care unit was 1 day. Duration of hospitalization — 3 days. According to the ultrasound examination performed 1, 3 and 6 months after the operation, there were no signs of recurrence of the disease in the form of residual accumulation of fluid associated with the spleen parenchyma.
CONCLUSION
The experience presented in the scientific study is encouraging and confirms the feasibility and safety of robot-assisted procedures in spleen surgery.
