Robotic assisted splenectomy after failure of splenic angioembolization in blunt abdominal trauma

Abstract

Traumatic blunt splenic injury in the hemodynamically stable patient is initially managed with a nonoperative strategy that may include angioembolization. If patients continue to have ongoing signs of bleeding after angioembolization, definitive management is surgical splenectomy. We report the case of a patient with a grade IV blunt splenic injury who had ongoing bleeding after angioembolization and was taken for diagnostic robotic surgery. An isolated splenic injury was identified and the patient was treated with robotic splenectomy. On one month follow up the patient was noted to be doing well with minimal pain. To our knowledge, this is the first report of robotic splenectomy after failed non-operative manage in the setting of trauma. This case shows the potential value of robotic surgery to apply the benefits of minimally invasive surgery in hemodynamically stable patients who fail non-operative management after traumatic splenic injury.