First experience of robotic cystectomy and partial splenectomy in a child with congenital splenic cyst

Volume 4, Issue 2, April 2019     |     PP. 39-51      |     PDF (302 K)    |     Pub. Date: April 9, 2019
DOI:    294 Downloads     6536 Views  

Author(s)

Yuanhong Xiao, Department of Pediatric Surgery, Chinese PLA General Hospital, Beijing, 100853, China
Gang Wang, Department of 2nd Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, 100853, China
Xuan Zhang, Department of 2nd Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, 100853, China
Guodong Zhao, Department of 2nd Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, 100853, China
Qu Liu, Department of 2nd Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, 100853, China
Zhipeng Zhou, Department of 2nd Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, 100853, China
Minggen Hu, Department of 2nd Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, 100853, China

Abstract
Background Congenital splenic cyst of children is an uncommon lesion. Robotic manipulations for congenital splenic cyst of children have not been reported.
Methods A nine-year-old girl with cystic neoplasm originating from the middle-lower pole of spleen was performed robotic cystectomy and partial splenectomy. 5 ports of robotic instrument assignment were applied. After cystic fluid aspiration, the collapsed cyst was excised using Harmonic scalpel accompanied with margin portion of splenic parenchyma adjacent to the cyst. The inner surface of cyst overlying the splenic parenchyma was obliterated by argon beam coagulation. The wound was covered with hemostatic agent and packed by greater omentum. The sample was placed in the retrieval bag and delivered out through the assisting port.
Results The total procedure time was 80 minutes, and the capnoperitonium time was 60 minutes. The blood loss was 15 ml with no blood transfusion. No abdominal drainage tube was used. The child recovered without complications. She was discharged 10 days after operation. Pathological diagnosis was splenic cyst.
Conclusion This case supports that robotic cystectomy and partial splenectomy may be safe and feasible in pediatric congenital slplenic cyst patients.

Keywords
Child, Cysts, Minimally invasive surgical procedures，Spleen, Splenic-neoplasms.

Cite this paper
Yuanhong Xiao, Gang Wang, Xuan Zhang, Guodong Zhao, Qu Liu, Zhipeng Zhou, Minggen Hu, First experience of robotic cystectomy and partial splenectomy in a child with congenital splenic cyst , SCIREA Journal of Clinical Medicine. Volume 4, Issue 2, April 2019 | PP. 39-51.

References

[ 1 ] Jay L. Grosfeld, James A. O’nell, Jr., Eric W. Fonkalsrud, Arnold G. Coran. Pediatric Surgery. In: Takeshi Miyano, editor. The pancreas. Philadelphia; Mosby Elsevier; 2006. p. 1683-1686.
[ 2 ] Keith T. Oldham, Paul M. Colombani, Robert P. Foglia. Surgery of Infants and Chilren: Scientific Principles and Practice. In: Daniel L, Mollitt and Maryanne L, Dokler, editors. Spleen. Philadelphia; Lippincott-Raven;. 1997. p. 1434.
[ 3 ] Morgenstern,-L. Nonparasitic splenic cysts: pathogenesis, classification, and treatment. J Am Coll Surg. 2002; 194: 306-14.
[ 4 ] Chapman,-W-H 3rd, Albrecht,-R-J, Kim,-V-B, Young,-J-A, Chitwood,-W-R Jr. Computer-assisted laparoscopic splenectomy with the da Vinci surgical robot. J Laparoendosc Adv Tech A. 2002; 12:155.
[ 5 ] Luebbe B, Woo R, Wolf S, et al. Robotically assisted minimal invasive surgery in a pediatric population: Initial experience, technical considerations, and description of the da Vinci Surgical System. Pediatr Endosurg Innovative Tech. 2003; 7: 385.
[ 6 ] Vasilescu,-C, Stanciulea,-O, Tudor,-S. Laparoscopic versus robotic subtotal splenectomy in hereditary spherocytosis. Potential advantages and limits of an expensive approach. Surg Endosc. 2012; 26: 2802-9.
[ 7 ] Silecchia-G, Fabiano,-P, Raparelli,-L, Perrotta,-N, Greco,-F, Clementi,-M, et al. Laparoscopic splenectomy: analysis of 60 consecutive cases. Chir Ital. 2002; 54: 295-300.
[ 8 ] Wootton-Gorges,-S-L, Thomas,-K-B, Harned,-R-K, Wu,-S-R, Stein-Wexler,-R, Strain,-J-D. Giant cystic abdominal masses in children. Pediatr Radiol. 2005; 35: 1277-88.
[ 9 ] Vasilescu,-C, Stanciulea,-O, Tudor,-S; Stanescu,-D, Colita,-A, Stoia,-R, et al. Laparoscopic subtotal splenectomy in hereditary spherocytosis: to preserve the upper or lower pole of the spleen. Surg Endosc. 2006; 20: 748-52.
[ 10 ] Vargun,-R, Gollu,-G, Fitoz,-S, Yagmurlu,-A. En-bloc stapling of the splenic hilum in laparoscopic splenectomy. Minim Invasive Ther Allied Technol. 2007; 16: 360-2.
[ 11 ] Meunier,-A, Closset,-J, Cassart,-M, Houben,-J-J, Lingier,-P. Management of congenital and posttraumatic splenic cysts in children. Hepatogastroenterology. 2008; 55: 286-8.
[ 12 ] Telem,-D, Chin,-E-H, Colon,-M, Nguyen,-S-Q, Weber,-K, Divino,-C-M. Minimally invasive surgery for splenic malignancies. Minerva Chir. 2008; 63: 529-40.
[ 13 ] Ntourakis,-D, Marzano,-E, Lopez-Penza,-P-A, Bachellier,-P, Jaeck,-D, Pessaux,-P. Robotic distal splenopancreatectomy: bridging the gap between pancreatic and minimal access surgery. J Gastrointest Surg. 2010; 14: 1326-30.
[ 14 ] Slater,-B-J, Chan,-F-P, Davis,-K, Dutta,-S. Institutional experience with laparoscopic partial splenectomy for hereditary spherocytosis. J Pediatr Surg. 2010; 45: 1682-6.
[ 15 ] Boybeyi,-O, Karnak,-I, Tanyel,-F-C, Ciftci,-A-O, Senocak,-M-E. The management of primary nonparasitic splenic cysts. Turk J Pediatr. 2010; 52: 500-4.
[ 16 ] Vajda,-P, Kereskai,-L, Czauderna,-P, Schaarschmidt,-K, Kalman,-A, Koltai,-J, Engelis,-A, Kalman,-E, Lewicki,-K, Verebely,-T, Jainsch,-M, Petersons,-A, Pinter,-A-B. Re-evaluation of histological findings of nonparasitic splenic cysts. Eur J Gastroenterol Hepatol. 2012; 24: 316-9.
[ 17 ] Zvizdic,-Z, Karavidic,-K. Spleen-preserving surgery in treatment of large mesothelial splenic cyst in children-a case report and review of the literature. Bosn J Basic Med Sci. 2013; 13: 126-8.
[ 18 ] Zhang,-Y, Chen,-X-M, Sun,-D-L, Yang,-C. Treatment of hemolymphangioma of the spleen by laparoscopic partial splenectomy: a case report. World J Surg Oncol. 2014; 12: 60.
[ 19 ] Seims,-A-D, Russell,-R-T, Beierle,-E-A, Chen,-M-K, Anderson,-S-A, Martin,-C-A, et al. Single-incision pediatric endosurgery (SIPES) splenectomy: what dictates the need for additional ports? Surg Endoscopy. 2015; 29: 30-3.