Surgical Endoscopy

, Volume 25, Issue 4, pp 1101–1106

Initial experiences using robot-assisted central pancreatectomy with pancreaticogastrostomy: a potential way to advanced laparoscopic pancreatectomy

  • Chang Moo Kang
  • Dong Hyun Kim
  • Woo Jung Lee
  • Hoon Sang Chi
Article

DOI: 10.1007/s00464-010-1324-3

Cite this article as:
Kang, C.M., Kim, D.H., Lee, W.J. et al. Surg Endosc (2011) 25: 1101. doi:10.1007/s00464-010-1324-3

Abstract

Background

Benign and borderline malignant pancreatic tumors are increasing. Function-preserving and minimally invasive pancreatectomy may be an ideal approach for these tumors.

Methods

The authors retrospectively evaluated their initial experiences with five consecutive robotic central pancreatectomies (CPs). They also compared the perioperative outcome for open CPs performed in their institution.

Results

The five women in the study had a median age of 45 years (range 36–64 years). A solid pseudopapillary tumor of the pancreas was found in four patients, and a pancreatic endocrine tumor was found in one patient. The tumor was relatively small (median size, 1.5 cm; range, 1–2 cm). All remnant pancreases were managed using pancreaticogastrostomy. The median operation time was 480 min (range 360–480 min), and the median estimated intraoperative bleeding was 200 ml (range 100–600 ml). No transfusion was given during the perioperative period. The median hospital stay was 12 days (range 9–28 days). Only one patient experienced postoperative pancreatic fistula (grade B), which was managed using the percutaneous drainage procedure. No operative morality was noted. In a comparative analysis with open CP, the robotic CP group demonstrated a smaller asymptomatic (17 out of 10 patients vs none, p = 0.026) tumor (5.9 ± 6.4 vs 1.4 ± 0.4 cm; p = 0.055), a longer operation time (286.5 ± 90.2 vs 432.0 ± 65.7 min, p = 0.013), and less intraoperative bleeding (432.0 ± 65.7 vs 286.5 ± 90.2 ml, p = 0.013).

Conclusion

Central pancreatectomy can be selected carefully as an appropriate surgical option for benign and borderline malignant lesions limited to the pancreatic neck area. The robotic surgical system may allow surgeons to perform complex and difficult laparoscopic procedures more easily, effectively, and precisely.

Keywords

Central pancreatectomyRobotic surgery

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Chang Moo Kang
    • 1
    • 2
  • Dong Hyun Kim
    • 3
  • Woo Jung Lee
    • 1
    • 2
  • Hoon Sang Chi
    • 1
    • 2
  1. 1.Division of Biliopancreas, Department of SurgeryYonsei University College of MedicineSeoulKorea
  2. 2.Clinic of Pancreatic and Biliary CancerInstitute of Gastroenterology, Yonsei University Health SystemSeoulKorea
  3. 3.Department of SurgeryYonsei University Wonju College of Medicine, Wonju Christian HospitalWonjuKorea