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Surgical Endoscopy

, Volume 32, Issue 2, pp 1056–1065 | Cite as

Safety and feasibility of the robotic platform in the management of surgical sequelae of chronic pancreatitis

  • Ahmad Hamad
  • Mazen S. Zenati
  • Trang K. Nguyen
  • Melissa E. Hogg
  • Herbert J. ZehIII
  • Amer H. ZureikatEmail author
Dynamic Manuscript

Abstract

Background/Aim

The application of minimally invasive surgery to chronic pancreatitis (CP) procedures is uncommon. Our objective was to report the safety and feasibility of the robotic approach in the treatment of surgical sequelae of CP, and provide insights into the technique, tricks, and pitfalls associated with the application of robotics to this challenging disease entity.

Methods

A retrospective review of a prospectively maintained database of patients undergoing robotic-assisted resections and/or drainage procedures for CP at the University of Pittsburgh between May 2009 and January 2017 was performed. A video of a robotic Frey procedure is also shown.

Results

Of 812 robotic pancreatic resections and reconstructions 39 were for CP indications. These included 11 total pancreatectomies [with and without auto islet transplantation], 8 Puestow procedures, 4 Frey procedures, 6 pancreaticoduodenectomies, and 10 distal pancreatectomies. Median age was 49, and 41% of the patients were female. The most common etiology for CP was idiopathic pancreatitis (n = 16, 46%). Median operative time was 324 min with a median estimated blood loss of 250 ml. None of the patients required conversion to laparotomy. A Clavien III–IV complication rate was experienced by 5 (13%) patients, including one reoperation. Excluding the eleven patients who underwent TP, rate of clinically relevant postoperative pancreatic fistula was 7% (Grade B = 2, Grade C = 0). No 30 or 90 day mortalities were recorded. The median length of hospital stay was 7 days.

Conclusions

Use of the robotic platform is safe and feasible when tackling complex pancreatic resections for sequelae of chronic pancreatitis.

Keywords

Chronic pancreatitis Robotic surgery Frey Puestow Total pancreatectomy Pancreatectomy 

Notes

Compliance with ethical standards

Disclosures

Drs. Ahmad Hamad, Mazen Zenati, Trang Nguyen, Melissa Hogg, Herbert Zeh, and Amer Zureikat have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 341853 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Ahmad Hamad
    • 1
  • Mazen S. Zenati
    • 1
    • 2
  • Trang K. Nguyen
    • 2
  • Melissa E. Hogg
    • 1
  • Herbert J. ZehIII
    • 1
  • Amer H. Zureikat
    • 1
    Email author
  1. 1.Division of Surgical Oncology, Department of Surgery, UPMC Pancreatic Cancer CenterUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of EpidemiologyUniversity of PittsburghPittsburghUSA

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