Background : Da Vinci SP system is increasingly being recognized for its utility across various surgical fields. One notable advantage is the ability to reduce the number of scars by using only one trocars. Due to the positional and anatomical characteristics of the spleen, single-incision laparoscopic splenectomy is a highly challenging procedure. Additionally, significant bleeding can occur in some cases, requiring meticulous handling. In this presentation, the author aims to report that effective surgery can be performed using only two trocars (single +1) with the Da Vinci SP system.

Methods : We used a single umbilical port with about 3cm of incision, and an additional trocar placed in the left abdomen for energy devices, a laparoscopic stapler, and drain insertion, an assistant used it. We performed this procedure for five female patients with age from 27 to 67, BMI from 17.41 to 31.02kg/m², and four of them had spleen tumors and the other had hemolytic anemia.

Results : Three cases took 80 minutes in console time, the others with obesity (BMI 30kg/m²) took 130 and 170 minutes. The spleen hilum was divided using a stapler. No one had estimated blood loss larger than 30cc and surgical complication, and every patient discharged on the postoperative day four.

Conclusions : The Da Vinci SP system offers a viable and effective approach for robotic-assisted splenectomy, particularly in cases requiring meticulous dissection and minimal invasiveness. This case highlights the system’s potential to enhance outcomes in splenic surgery, warranting further exploration in the field.