Abstract
Background
Central pancreatectomy (CP) is increasingly being used to treat selected lesions of the central pancreatic segment. A stepโbyโstep technique for robotic CP is described and a literature review provided for this minimally invasive approach.
Methods
A 55โyearโold woman was referred to the authors' center for the treatment of a single 4 cm lesion located at the proximal part of the pancreatic body. The da Vinci Robotic surgical systemยฎ with a five trocar technique was used. The pancreatic neck was transected using an endoscopic stapler. The pancreatic body was progressively dissected from the splenic vessels right to left and sectioned with an appropriate oncologic margin. A pancreaticogastrostomy protected by a transanastomotic external stent was constructed to the distal pancreatic stump.
Results
Surgery lasted 450 min (8 min docking time) with minimal blood loss. Pathology showed a 28 mm wellโdifferentiated neuroendocrine pancreatic tumor with tumorโfree resection margins. The patient was discharged home on postoperative day 15 in good condition.
Conclusions
Robotic surgery can be safely used for complex pancreatic resection requiring pancreaticoenteric reconstruction. The experience reported so far is still limited but the results are encouraging; robotics shows the potential to bridge the gap between minimally invasive surgery and advanced pancreatic surgery. Copyright ยฉ 2011 John Wiley & Sons, Ltd.