Robotic Resection of Intraductal Neoplasm of the Pancreas

Abstract

Background: Minimally invasive techniques have been revolutionary and provide clinical evidence of decreased morbidity and comparable efficacy to traditional open surgery. Computer-assisted surgical devices have recently been approved for general surgical use. Aim: The aim of this study was to report the first known case of pancreatic resection with the use of a computerassisted, or robotic, surgical device in Latin America. Patient and Method: A 37-year-old female with a previous history of radical mastectomy for bilateral breast cancer due to a BRCA2 mutation presented with an acute pancreatitis episode. Radiologic investigation disclosed an intraductal pancreatic neoplasm located in the neck of the pancreas with atrophy of the body and tail. The main pancreatic duct was enlarged. The surgical decision was to perform a laparoscopic subtotal pancreatectomy, using the da Vinci Ò robotic system (Intuitive Surgical, Sunnyvale, CA). Five trocars were used. Pancreatic transection was achieved with vascular endoscopic stapler. The surgical specimen was removed without an additional incision. Results: Operative time was 240 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions: The subtotal laparoscopic pancreatic resection can safely be performed. The da Vinci robotic system allowed for technical refinements of laparoscopic pancreatic resection. Robotic assistance improved the dissection and control of major blood vessels due to three-dimensional visualization of the operative field and instruments with wrist-type end-effectors.

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

“…Although we have performed the first robotic pancreatectomy in Latin America (14) in 2008, we did not find any advantage over standard laparoscopic pancreatectomy. We believe that given the higher costs this aid should be reserved for more complex operations.…”

Robotic Distal Splenopancreatectomy: Bridging the Gap Between Pancreatic and Minimal Access Surgery

“…10,11 In our experience it offers many advantages in the context of distal splenopancreatectomy even though it has a difficult learning curve. If haptic and force feedback interfaces become available in the future, robotic-assisted surgery will stride many steps closer to the open surgical experience.…”

Ultra‐minimally invasive local immune cell therapy and regenerative therapy by multi‐piercing surgery for abdominal solid tumor: therapeutic simulation by natural orifice translumenal endoscopic surgery‐assisted needlescopic surgery using 3‐mm diameter robots

“…Robots are considered useful, especially for gastrointestinal tract anastomoses [3] and vascular anastomoses. There have been reports of pancreatectomy conducted by robotic surgery allowing the entire surgical procedure to be conducted under endoscopy [4, 5]. However, conventional robots are too invasive to be used for local surgery such as cell infusion therapy and lymph node sampling.…”