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Surgical Endoscopy

, Volume 24, Issue 7, pp 1646–1657 | Cite as

Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience

  • Pier Cristoforo Giulianotti
  • Fabio Sbrana
  • Francesco Maria Bianco
  • Enrique Fernando Elli
  • Galaxy Shah
  • Pietro Addeo
  • Giuseppe Caravaglios
  • Andrea Coratti
Article

Abstract

Background

Use of robotic surgery has gained increasing acceptance over the last few years. There are few reports, however, on advanced pancreatic robotic surgery. In fact, the indication for robotic surgery in pancreatic disease has been controversial. This paper retrospectively reviews one surgeon’s experience with robotic surgery to treat pancreatic disease, and analyzes its indications and outcomes, as well as the controversy that exists.

Methods

A retrospective review of the charts of all patients who underwent robotic surgery for pancreatic disease by a single surgeon at two different institutions was carried out.

Results

From October 2000 to January 2009, 134 patients underwent robotic-assisted surgery for different pancreatic pathologies. All procedures were performed using the da Vinci robotic system. Of the 134 patients, 83 were female. The average age of all patients was 57 years (range 24–86 years). Mean operating room (OR) time was 331 min (75–660 min). There were 14 conversions to open surgery. Mean length of stay was 9.3 days (3–85 days). Length of stay for patients with no complications was 7.9 days (3–15 days). The postoperative morbidity rate was 26% and the mortality rate was 2.23% (three patients). Among the procedures performed were 60 pancreaticoduodenectomies, 23 spleen-preserving distal pancreatectomies, 23 splenopancreatectomies, 3 middle pancreatectomies, 1 total pancreatectomy, and 3 enucleations. Another 21 patients underwent different surgical procedures for treatment of acute and chronic pancreatitis. Two cases of pancreaticoduodenectomy were performed in outside institutions and are not included in this series.

Conclusions

This is the largest series of robotic pancreatic surgery presented to date. Robotic surgery enables difficult technical maneuvers to be performed that facilitate the success of pancreatic minimally invasive surgery. The results in this series demonstrate that it is feasible and safe. Complication and mortality rates are comparable to those of open surgery but with the advantages of minimally invasive surgery.

Keywords

Robotic surgery Pancreatic resection Chronic pancreatitis Distal pancreatectomy Minimally invasive surgery 

Notes

Disclosures

Dr. Pier Cristoforo Giulianotti MD, Dr. Fabio Sbrana MD, Dr. Francesco Maria Bianco MD, Dr. Enrique Fernando Elli MD, Dr. Galaxy Shah MD, Dr. Pietro Addeo MD, Dr. Giuseppe Caravaglios MD, and Dr. Andrea Coratti MD have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Pier Cristoforo Giulianotti
    • 1
  • Fabio Sbrana
    • 1
  • Francesco Maria Bianco
    • 1
  • Enrique Fernando Elli
    • 1
  • Galaxy Shah
    • 1
  • Pietro Addeo
    • 1
  • Giuseppe Caravaglios
    • 2
  • Andrea Coratti
    • 2
  1. 1.Division of General, Minimally Invasive and Robotic Surgery, Department of SurgeryUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Department of General SurgeryOspedale MisericordiaGrossetoItaly

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