Final answer:
The optimal course of action for troublesome bleeding from an injured inferior pole of the spleen during surgery is sutured splenorrhaphy, which allows for the preservation of spleen function.
Step-by-step explanation:
If the inferior pole of the spleen is injured during an open Watsons Fundoplication, causing troublesome bleeding, the best course of action would typically be sutured splenorrhaphy. This procedure involves suturing the capsule of the spleen to control the hemorrhage and preserves spleen function. Total splenectomy should be considered only when other methods fail or when the injury is extensive, since the spleen plays a critical role in blood filtration and immune system function.