Laparoscopic splenectomy: conventional versus robotic approach: a comparative study. “19° international congress and endo-expo of SLS

Objectives: Laparoscopic splenectomy (LS) is the gold standard in surgical treatment of splenic hematologic diseases. Robotic surgery (RS) has changed the concept of minimally invasive surgery because of the tridimensional view, degrees of freedom, and accuracy of movements. The aim of this study was to evaluate whether RS has advantages over LS.Methods: In 2 Surgical Units experienced in laparoscopic spleen surgery, 2 groups of patients underwent LS (45 cases G1) and RS (45 cases G2). The 2 groups were well matched for demographic characteristic, indications, and spleen size. The median bipolar spleen diameter was 15cm and 13cm, respectively.Results: Between the 2 groups, there were no statistically significant differences in intraoperative blood loss (<100mL in both groups), conversion rate to laparotomy (5 G1, 4 G2), postoperative food intake, drainage removal, postoperative complications (4 hemoperitoneum and 1 pleural effusion G1, 1 hemoperitoneum and 4 pleural effusion G2) and median postoperative hospital stay. On the contrary, statistically significant differences were observed for median operative time (125 minutes G1, 153 G2) and costs (US$1.600 G1, US$6.930 G2). Transfusion and mortality rate were 0%. The follow-up at 6 months does not highlight late-surgical complications.Conclusion: The analysis of the data does not show advantages of RS over LS. RS even though it offers a tridimensional view of the operative field and the degrees of freedom and accuracy of movement that are superior to that of LS, has longer operative time and higher costs. Therefore, we can conclude that LS is to be considered the gold standard for hematological diseases.