Robot-assisted partial splenectomy for benign splenic tumors: Four case reports

Figure 1 Imaging examinations of four patients. A and B: Computed tomography (CT) revealed a round, non-enhancing low-density lesion measuring approximately 90 mm in the lower pole of the spleen (arrows), which was consistent with a splenic cyst; C and D: CT revealed multiple oval-shaped low-density lesions in the upper segment of the spleen (arrows), with the largest measuring approximately 52 mm; E and F: Magnetic resonance imaging revealed a 40 mm well-defined mass in the lower pole of the spleen (arrows), which appears as a low signal on T1 weight and a high signal on T2 weight; G and H: CT revealed a round, non-enhancing low-density lesion measuring approximately 73 mm in the lower pole of the spleen (arrows).

Figure 2 Schematic illustration of the port positions. Port 1 is for the Cadiere forceps; Port 2 is for the Maryland bipolar forceps; Port 3 is for the laparoscope; Port 4 is for an ultrasonic scalpel or permanent cautery hook; and Port 5 is a port for assistance.

Figure 3 The detailed surgical procedure of robotic-assisted partial splenectomy. A: The gastrocolic ligament was incised to expose the pancreas and spleen; B: The splenic artery was slung with nylon tape; C and D: The splenic hilum was exposed, and the segment vessels of the pre-resected segment were cut; E: Bleeding points on the cut surface were cauterized using a permanent cautery hook; F: Hemostatic gauze was used on the splenic edge.

Figure 4 The patient 1's pathology result and postoperative computed tomography images. A: Resected specimen from patient 1. The contents of the cyst had already leaked out; B: Histopathological analysis and immunohistochemical examination of the resected specimen: Primary splenic cyst; C and D: Computed tomography (CT) images of patient 1 on the third day after surgery. There was some effusion around the spleen (arrows); E: A follow-up CT scan of patient 1 at six months post-surgery revealed that there was no tumor in the spleen.

Figure 5 The patient 2's pathology result and postoperative computed tomography images. A: Resected specimen from patient 2; B: Histopathological analysis and immunohistochemical examination of the resected specimen: Splenic hemangiomas; C and D: Computed tomography (CT) images of patient 2 on the third day after surgery. There was some effusion above the spleen (arrows); E and F: A follow-up CT scan of patient 2 at six months post-surgery indicated that there were no tumors in the spleen (arrows).

Figure 6 The patient 3's pathology result and postoperative computed tomography images. A: Resected specimen from patient 3; B: Histopathological analysis and immunohistochemical examination of the resected specimen: Splenic hemangiomas; C and D: Computed tomography (CT) images of patient 3 on the third day after surgery. There was some effusion above the spleen (arrows); E and F: A follow-up CT scan of patient 3 at six months post-surgery indicated that there was no tumor in the spleen (arrows).

Figure 7 The patient 4's pathology result and postoperative computed tomography images. A and B: Resected specimen from patient 4; C: Histopathological analysis and immunohistochemical examination of the resected specimen: Splenic cyst; D: Computed tomography (CT) images of patient 4 on the third day after surgery. There was some effusion above the spleen (arrows); E: A follow-up CT scan of patient 4 at six months post-surgery indicated that there was no tumor in the spleen (arrows).