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Single-Incision Robotic Splenectomy Using the da Vinci SP System with an Additional Trocar
Yeongsoo Jo, Seog Ki Min
Received March 25, 2026  Accepted June 8, 2026  Published online June 19, 2026  
DOI: https://doi.org/10.69474/jsie.2026.00017    [Epub ahead of print]
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The da Vinci SP system has been increasingly used in several surgical fields, partly because it can reduce the number of abdominal incisions by enabling surgery through a single access port. However, single-incision laparoscopic splenectomy is technically demanding because of the spleen’s anatomical position and vascularity, and significant bleeding may occur without meticulous hilar and perisplenic dissection. This report describes a robotic splenectomy performed with the da Vinci SP system using a single-port-plus-one approach. A single umbilical access port was placed through an approximately 3-cm incision, and an additional trocar was inserted in the left abdomen for use by the assistant, including introduction of energy devices, a laparoscopic stapler, and a drain. We present a representative case treated using this approach. The patient was a 42-year-old woman with hemolytic anemia, hyperbilirubinemia, a body mass index of 24.2 kg/m2, and splenomegaly measuring 15.1 cm in maximal craniocaudal diameter. The console time was 100 minutes, and the estimated blood loss was 10 mL. The splenic hilum was divided using a laparoscopic stapler. No surgical complications occurred, and the patient was discharged on postoperative day 3. Robotic splenectomy using the da Vinci SP system with an additional assistant trocar was technically feasible in this carefully selected patient. Further studies are needed to determine its safety, indications, and comparative advantages over conventional laparoscopic or multiport robotic approaches.

JSIE : Journal of Surgical Innovation and Education
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