Case Report: Single-port robotic-assisted partial splenectomy for a giant congenital splenic cyst in a child using the SHURUI system.

INTRODUCTION

Congenital splenic cysts are rare in children. When cysts become large or symptomatic, surgical intervention may be required. Because total splenectomy increases the risk of overwhelming post-splenectomy infection, spleen-preserving procedures are generally preferred whenever technically feasible. With the development of minimally invasive surgery, robotic platforms may provide technical advantages in complex spleen-preserving procedures. However, experience with single-port robotic surgery for pediatric splenic cysts remains extremely limited.

CASE DESCRIPTION: We report the case of a 9-year-old boy weighing 33.5 kg who presented with progressive abdominal distension. Preoperative ultrasonography and computed tomography demonstrated a giant splenic cystic lesion with marked mass effect on adjacent structures. Given the lesion size and the need to preserve splenic function, single-port robotic-assisted partial splenectomy using the SHURUI system was performed. The cyst was decompressed first, followed by selective control of the segmental splenic vessels with hemoclips and demarcation-guided parenchymal transection. The operation was completed successfully without conversion or intraoperative complications. Estimated blood loss was approximately 20 mL, and the patient was discharged on postoperative day 6. Pathological examination, supported by immunohistochemistry, confirmed a congenital epithelial splenic cyst. At 3-month follow-up, the patient remained asymptomatic, with satisfactory residual splenic morphology and no evidence of recurrence. Additionally, he had resumed competitive sports without any limitations at 6-month follow-up.

DISCUSSION: This case suggests that single-port robotic-assisted partial splenectomy using the SHURUI system is feasible in selected pediatric patients with giant congenital splenic cysts. The procedure provided adequate exposure, precise dissection, and satisfactory spleen preservation through a transumbilical approach. Although the experience is limited to a single case and longer follow-up is required, this report adds to the emerging evidence supporting robotic spleen-preserving surgery in children.