Background : Hematologic conditions such as hereditary spherocytosis and sickle cell disease are frequently linked to cholelithiasis and simultaneous cholecystectomy and splenectomy are commonly recommended. To concomitantly excise them by a minimally invasive approach is far more attractive than traditional open approach. We report our initial experience of simultaneous robotic single port cholecystectomy and splenectomy using the daVinci SP system. To our knowledge, this is the first report in Korea regarding simultaneous robotic single port cholecystectomy and splenectomy using the new daVinci SP system.

Methods : An eight-year-old male previously diagnosed with Hereditary Spherocytosis was referred to our department for jaundice due to bile duct stone and splenomegaly. The SP cannula was inserted through a 3 cm pfannenstiel incision.

Results : The cystic duct and artery were dissected and ligated with hem-o-lok clips. After cholecystectomy, dissection of the perisplenic area was performed after relocating the SP working port using the navigation paddle. Also the so called “cobra view” function of the flexible robot camera was used for dissection and visualization of splenic hilar structures. After encircling the hilar structures, they were transected using an endo GIA stapler. The total operation time was 115 minutes. The docking time was 1 minutes and the console time was 59 minutes. Length of hospital stay was 9 days after surgery.

Conclusions : Simultaneous robotic-assisted splenectomy and cholecystectomy can be considered safe and feasible interventions in children with hematological diseases that affect both the spleen and the gallbladder. However, further research is needed to enhance the existing evidence and establish a standardized approach.