Our Summary

This research paper is about a study that compares two types of surgical procedures to remove the spleen in children: Robotic Assisted Splenectomy (RAS) and Laparoscopic Splenectomy (LAS). The study was conducted over 9 years, from 2011 to 2020, and included 41 cases.

The researchers found that while both procedures are safe, RAS takes much longer (about 223 minutes) than LAS (approximately 97 minutes). However, children who underwent RAS had a slightly shorter hospital stay (5 days) than those who had LAS (6.5 days).

The study also showed that the amount of pain medication used was about the same for both procedures. The complexity of the surgeries was also comparable in both groups.

One interesting finding was that the results of RAS improved over time, as the surgeon became more experienced with the procedure. However, despite this improvement, RAS did not show any additional benefits compared to LAS, and it was more expensive and time-consuming.

In conclusion, while RAS is a safe method for spleen removal in children, it does not offer any distinct advantages over LAS, and it requires more resources.

FAQs

  1. What were the main findings of the study comparing Robotic Assisted Splenectomy (RAS) and Laparoscopic Splenectomy (LAS) in children?
  2. Did the study show any improvement in the results of RAS over time?
  3. Does the study suggest any benefits of RAS over LAS in terms of hospital stay and use of pain medication?

Doctor’s Tip

Therefore, a doctor might advise a patient considering splenectomy to discuss with their healthcare provider the potential benefits and drawbacks of both RAS and LAS, taking into consideration factors such as length of surgery, hospital stay, cost, and recovery time. It is important for the patient to make an informed decision based on their individual needs and circumstances.

Suitable For

Patients who are typically recommended for splenectomy include those with conditions such as hereditary spherocytosis, immune thrombocytopenic purpura (ITP), thalassemia, and certain types of cancers. In cases where other treatment options have been unsuccessful or the patient is at risk of complications due to their condition, splenectomy may be recommended as a last resort.

It is important for healthcare providers to carefully consider the risks and benefits of splenectomy for each individual patient, taking into account their specific medical history and condition. Additionally, the choice between RAS and LAS should be made based on factors such as the surgeon’s experience and expertise, as well as the resources available at the healthcare facility. Ultimately, the goal is to provide the best possible outcomes for the patient while minimizing risks and complications associated with the procedure.

Timeline

Before splenectomy:

  • Patient undergoes preoperative evaluation and testing to determine if surgery is necessary.
  • Patient is informed about the risks and benefits of the procedure.
  • Surgery is scheduled and patient may need to follow certain preoperative instructions, such as fasting.
  • Patient is admitted to the hospital on the day of surgery.

After splenectomy:

  • Patient undergoes the surgical procedure to remove the spleen.
  • Patient is monitored in the recovery room before being transferred to a hospital room.
  • Patient may experience pain and discomfort, which is managed with medication.
  • Patient is encouraged to move around and resume normal activities gradually.
  • Patient is discharged from the hospital when deemed stable and may need to follow postoperative instructions for recovery.

Overall, the timeline for a patient before and after splenectomy involves preparation for surgery, undergoing the procedure, and recovering with proper care and monitoring.

What to Ask Your Doctor

Some questions that a patient should ask their doctor about splenectomy include:

  1. What are the potential risks and complications associated with splenectomy?
  2. How will my recovery process differ between robotic-assisted splenectomy and laparoscopic splenectomy?
  3. What is the expected length of hospital stay for each procedure?
  4. How experienced is the surgical team in performing robotic-assisted splenectomy or laparoscopic splenectomy?
  5. What are the long-term effects of living without a spleen?
  6. Will I need any additional vaccinations or medications after the spleen removal?
  7. How will my follow-up care differ between the two procedures?
  8. What is the cost difference between robotic-assisted splenectomy and laparoscopic splenectomy?
  9. Are there any specific dietary or lifestyle changes I should make after the surgery?
  10. Are there any alternative treatment options to consider before proceeding with splenectomy?

Reference

Authors: Belbahri I, Planchamp T, Ait Aissa D, Larcher C, Mouttalib S, Le Mandat A, Abbo O. Journal: J Laparoendosc Adv Surg Tech A. 2023 Jul;33(7):703-706. doi: 10.1089/lap.2022.0075. Epub 2023 Jun 9. PMID: 37294936