Robotic splenectomy with ex vivo bench surgery and hemi-spleen autotransplant: the first report

Laparoscopic partial splenectomy for a giant splenic pseudocyst with elevated CA19-9: a case report

Introduction and importance

Currently, there is a lack of reliable evidence on the management of splenic cysts, which are rare. Exploring the efficacy of laparoscopic partial splenectomy can aid in the accumulation of treatment-related evidence.

Case presentation

Here, we report the case of a 31-year-old female who was diagnosed with a giant splenic cyst with elevated serum CA19-9 and subsequently underwent laparoscopic partial splenectomy.

Clinical discussion

The effects of most treatment options for splenic cysts, including percutaneous aspiration and drainage, fenestration, and partial splenectomy, have not been confirmed by high-level evidence. With the development of minimally invasive surgery, laparoscopic partial splenectomy has drawn increasing attention. Additionally, the relationships between tumor markers and splenic cysts need to be further elucidated.

Conclusions

Laparoscopic partial splenectomy might be recommended for patients with splenic cysts, especially when the cysts are not completely covered by the splenic parenchyma.

Hand-Assisted Laparoscopic Splenectomy with Temporary Splenic Artery Occlusion in Pediatric Patients: The Experience in a Chinese Tertiary Children's Hospital

Background: The hand-assisted laparoscopic splenectomy (HALS) approach overcomes the difficulties experienced with conventional laparoscopic splenectomy (LS) with added advantages. In this study, we compared the HALS technique with standard LS based on the feasibility and intermediate postoperative outcomes in pediatric patients. Methods: We retrospectively investigated pediatric patients who underwent HALS or LS from October 2013 to May 2021 at the Children's Hospital, Chongqing Medical University. Potential parameters related to HALS or LS were explored, and the intermediate-term clinical outcomes were compared between the two groups. The quality of life and splenic regrowth data were followed up routinely for 12 months after the operation. Results: In total, 39 patients underwent splenectomy (11 for HALS and 28 for LS) and were eligible for this research. Patients who underwent HALS had a greater proportion of focal benign splenic lesions (P < .001) and partial splenectomy (P < .001). The HALS operative time was reduced compared with LS (P = .032). No operation conversion was noted in the HALS group, whereas 4 (14.3%) cases were converted to an open operation (P = .249). For partial splenectomies, favorable outcomes with HALS, including short operative time (P = .001) and reduced blood loss (P = .014), were noted compared with LS. No postoperative mortality was observed. During the follow-up period, a good quality of life and splenic regrowth were noted for most of the patients. Conclusions: Although another incision is necessary, HALS confers the advantages of a minimally invasive technique to manage the fragile spleen, especially in pediatric patients requiring partial splenectomy.