{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:20:06Z","timestamp":1791811206638,"version":"4.3.4"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Isolated parenchymal splenic relapse is a rare condition experienced by patients presenting with recurrent ovarian cancer (ROC).<jats:sup>1\u20133<\/jats:sup> In such cases, complete secondary cytoreductive surgery (SCS) followed by chemotherapy offers significant overall survival benefits for platinum-sensitive ROC patients. Randomized trials such as DESKTOP-3 and SOC-1 described splenectomy during SCS in 6\u201315% of patients.<jats:sup>4,5<\/jats:sup> Robotic-assisted surgery (RAS) and advanced three-dimensional (3D) imaging reconstruction can be integrated when choosing minimally invasive surgery (MIS) to reduce the risks associated with splenic procedures.<jats:sup>6\u20138<\/jats:sup>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methodology<\/jats:title>\n            <jats:p>The case of a 70-year-old BRCA2-mutated patient with single-site splenic ROC is presented. Computed tomography (CT) scan was reviewed by an expert radiologist during a multidisciplinary tumor board. The images were manually segmented using 3D Slicer software to obtain the final 3D reconstruction.<jats:sup>9<\/jats:sup> Using the da Vinci Xi\u2122 robot (Intuitive Surgical, Sunnyvale, CA, USA), a medial-to-lateral spleen dissection was performed. Several key surgical steps were followed to avoid tumor manipulation and subsequently minimize potential neoplastic spread.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Intraoperative ultrasound confirmed lesion localization, and advanced robotic instruments facilitated precise hilum control, reducing the risk of bleeding and pancreatic tail injury. Robotic SCS with complete tumor resection was achieved. No intraoperative or postoperative complications were reported. Final histology confirmed the diagnosis of high-grade ROC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>RAS represents a viable option for SCS in ROC patients with isolated parenchymal localization. The integration of 3D reconstruction with RAS allows for a tailored approach in complex cases. A high-level of expertise and appropriate identification of candidates for MIS-SCS are required to achieve the best outcomes for ROC patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1245\/s10434-025-17183-2","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T19:26:19Z","timestamp":1742325979000},"page":"4324-4325","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic Secondary Cytoreduction with 3D Reconstruction for Isolated Recurrent Ovarian Cancer: A Stepwise Approach to Splenectomy"],"prefix":"10.1245","volume":"32","author":[{"given":"Riccardo","family":"Oliva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rosati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Certelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Palmieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Giudice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Scaglione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Marescaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fagotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Gallotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"issue":"8","key":"17183_CR1","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1136\/ijgc-2020-001384","volume":"30","author":"TA Paterniti","year":"2020","unstructured":"Paterniti TA, Ahmad S, Holloway RW. Robotic-assisted laparoscopic splenectomy for recurrent ovarian cancer. Int J Gynecol Cancer. 2020;30(8):1189\u201394. https:\/\/doi.org\/10.1136\/ijgc-2020-001384.","journal-title":"Int J Gynecol Cancer."},{"issue":"3","key":"17183_CR2","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1016\/j.jmig.2016.01.001","volume":"23","author":"V Gallotta","year":"2016","unstructured":"Gallotta V, Nero C, Lodoli C, et al. Laparoscopic splenectomy for secondary cytoreduction in ovarian cancer patients with localized spleen recurrence: feasibility and technique. J Minim Invasive Gynecol. 2016;23(3):425\u20138. https:\/\/doi.org\/10.1016\/j.jmig.2016.01.001.","journal-title":"J Minim Invasive Gynecol."},{"key":"17183_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2023.102391","volume":"90","author":"V Gallotta","year":"2023","unstructured":"Gallotta V, Certelli C, Oliva R, et al. Robotic surgery in ovarian cancer. Best Pract Res Clin Obstet Gynaecol. 2023;90:102391. https:\/\/doi.org\/10.1016\/j.bpobgyn.2023.102391.","journal-title":"Best Pract Res Clin Obstet Gynaecol."},{"issue":"12","key":"17183_CR4","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1245\/s10434-006-9048-2","volume":"13","author":"N Manci","year":"2006","unstructured":"Manci N, Bellati F, Muzii L, et al. Splenectomy during secondary cytoreduction for ovarian cancer disease recurrence: surgical and survival data. Ann Surg Oncol. 2006;13(12):1717\u201323. https:\/\/doi.org\/10.1245\/s10434-006-9048-2.","journal-title":"Ann Surg Oncol."},{"issue":"23","key":"17183_CR5","doi-asserted-by":"publisher","first-page":"2123","DOI":"10.1056\/NEJMOA2103294","volume":"385","author":"P Harter","year":"2021","unstructured":"Harter P, Sehouli J, Vergote I, et al. Randomized trial of cytoreductive surgery for relapsed ovarian cancer. N Engl J Med. 2021;385(23):2123\u201331. https:\/\/doi.org\/10.1056\/NEJMOA2103294.","journal-title":"N Engl J Med."},{"issue":"4","key":"17183_CR6","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/S1470-2045(21)00006-1","volume":"22","author":"T Shi","year":"2021","unstructured":"Shi T, Zhu J, Feng Y, et al. Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer (SOC-1): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(4):439\u201349. https:\/\/doi.org\/10.1016\/S1470-2045(21)00006-1.","journal-title":"Lancet Oncol."},{"issue":"2","key":"17183_CR7","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.ygyno.2014.05.007","volume":"134","author":"PF Escobar","year":"2014","unstructured":"Escobar PF, Levinson KL, Magrina J, et al. Feasibility and perioperative outcomes of robotic-assisted surgery in the management of recurrent ovarian cancer: A multi-institutional study. Gynecol Oncol. 2014;134(2):253\u20136. https:\/\/doi.org\/10.1016\/j.ygyno.2014.05.007.","journal-title":"Gynecol Oncol."},{"issue":"9","key":"17183_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2024.108526","volume":"50","author":"C Certelli","year":"2024","unstructured":"Certelli C, Palmieri L, Federico A, et al. Robotic approach for the treatment of gynecological cancers recurrences: a ten-year single-institution experience. 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Riccardo Oliva, Andrea Rosati, Camilla Certelli, Luca Palmieri, Maria Teresa Giudice, Giulia Scaglione, Jacques Marescaux, Giovanni Scambia, and Valerio Gallotta have no conflicts of interest to declare that may be relevant to the contents of this article.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}