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Application of a commercial single-port device for robotic single-incision distal pancreatectomy: initial experience

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Abstract

Purpose

Laparoscopic distal pancreatectomy has proven to be feasible and safe. Moreover, robotic surgery provides unique advantages for pancreatic procedures, although single-incision robotic pancreatic surgery is rarely discussed. We applied the single-port modified platform to accomplish robotic distal pancreatectomy in a series of patients.

Methods

The subjects of this study were ten patients who underwent robotic distal pancreatectomy in our hospital between July 1, 2015 and Dec 31, 2016. All patients were placed supine in the reverse Trendelenburg position with the legs abducted. Surgery was performed via a trans-umbilical 5.0-cm incision, using a modified single-port platform (LAGIPORT®) combined with the da Vinci Si Surgical System. The three arms and scope (30-degree up) were inserted through the LAGIPORT® and positioned in a triangle. Endoscopic ultrasound was used to localize the tumor and plan the resection margin. We recorded the surgical time, operation time, blood loss, postoperative pain score, hospital stay, and complications.

Results

The surgical time was 236 ± 32 min, the operation time was 172 ± 30 min, and the blood loss was 149 ± 65 ml. All patients underwent robot-assisted distal pancreatectomy without conversion. The average pain score on postoperative day (POD) 3 was 4.5 ± 1. Complications included subsplenic hematoma (n = 1) and minor pancreatic leakage (n = 2). There was no surgical mortality.

Conclusions

Our results demonstrate the safety and efficiency of robotic single-incision distal pancreatectomy via the modified platform (LAGIPORT®).

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References

  1. Daouadi M, Zureikat AH, Zenati MS, Choudry H, Tsung A, Bartlett DL, et al. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg. 2013;257(1):128–32. https://doi.org/10.1097/SLA.0b013e31825fff08

    Article  PubMed  Google Scholar 

  2. Zureikat AH, Moser AJ, Boone BA, Bartlett DL, Zenati M, Zeh HJ. 3rd. 250 robotic pancreatic resections: safety and feasibility. Ann Surg. 2013;258(4):554–9. https://doi.org/10.1097/SLA.0b013e3182a4e87 (discussion 9-62)

    Article  PubMed  PubMed Central  Google Scholar 

  3. Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, et al. Transumbilical single-port surgery: evolution and current status. Eur Urol. 2008;54(5):1020–9. https://doi.org/10.1016/j.eururo.2008.07.009.

    Article  PubMed  Google Scholar 

  4. Antoniou SA, Pointner R, Granderath FA. Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc. 2011;25(2):367–77. https://doi.org/10.1007/s00464-010-1217-5

  5. Machado MA, Surjan RC, Makdissi FF. First single-port laparoscopic pancreatectomy in Brazil. Arq Gastroenterol. 2013;50(4):310–2. https://doi.org/10.1590/S0004-28032013000400013.

    Article  PubMed  Google Scholar 

  6. Takahashi T, Takeuchi H, Kawakubo H, Saikawa Y, Wada N, Kitagawa Y. Single-incision laparoscopic surgery for partial gastrectomy in patients with a gastric submucosal tumor. Am Surg. 2012;78(4):447–50.

    PubMed  Google Scholar 

  7. Machado MA, Makdissi FF, Surjan RC. Single-port for laparoscopic gastric resection with a novel platform. Arq Bras Cir Dig. 2014;27(2):157–159.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Morel P, Pugin F, Bucher P, Buchs NC, Hagen ME. Robotic single-incision laparoscopic cholecystectomy. J Robot Surg. 2012;6(3):273–4. https://doi.org/10.1007/s11701-011-0310-7.

    Article  PubMed  Google Scholar 

  9. Kim SH, Kang CM, Lee WJ. Robotic single-site plus ONE port distal pancreatectomy. Surg Endosc. 2017;31(10):4258–9. https://doi.org/10.1007/s00464-017-5476-2.

    Article  PubMed  Google Scholar 

  10. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13. https://doi.org/10.1016/j.surg.2005.05.001.

    Article  PubMed  Google Scholar 

  11. Joyce D, Morris-Stiff G, Falk GA, El-Hayek K, Chalikonda S, Walsh RM. Robotic surgery of the pancreas. World J Gastroenterol. 2014;20(40):14726–32. https://doi.org/10.3748/wjg.v20.i40.14726.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hashimoto M, Watanabe G, Matsuda M, Mori M. Serous cystic neoplasm of the pancreas-indications for surgery. Hepatogastroenterology. 2006;53(72):950–2.

    PubMed  Google Scholar 

  13. Far SS, Miraj S. Single-incision laparoscopy surgery: a systematic review. Electron Physician. 2016;8(10):3088–95. https://doi.org/10.19082/3088

    Article  PubMed  PubMed Central  Google Scholar 

  14. Podda M, Saba A, Porru F, Pisanu A. Systematic review with meta-analysis of studies comparing single-incision laparoscopic colectomy and multiport laparoscopic colectomy. Surg Endosc. 2016;30(11):4697 – 720. https://doi.org/10.1007/s00464-016-4812-2.

    Article  PubMed  Google Scholar 

  15. Escobar PF, Haber GP, Kaouk J, Kroh M, Chalikonda S, Falcone T. Single-port surgery: laboratory experience with the da Vinci single-site platform. JSLS. 2011;15(2):136–41. https://doi.org/10.4293/108680811X13022985132128.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, et al. Distal pancreatectomy: is staple closure beneficial? ANZ J Surg. 2003;73(11):922–5.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by the grants, FCU/CSMU104-001 from Feng Chia University/Chung Shan Medical University and MOST 105-2320-B-039-059-MY3 from the Ministry of Science and Technology.

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Authors and Affiliations

  1. Program of Electrical and Communications Engineering, Feng Chia University, No. 100, Wenhwa Rd., Seatwen, Taichung, 40724, Taiwan

    Cheng-Ming Peng & Yi-Jui Liu

  2. Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan

    Cheng-Ming Peng, Hsin-Cheng Liu, Ching-Lung Hsieh & Yao-Kun Yang

  3. Department of Automatic Control Engineering, Feng Chia University, No. 100, Wenhwa Rd., Seatwen, Taichung, 40724, Taiwan

    Teng-Chieh Cheng & Yi-Jui Liu

  4. Graduate Institute of Biomedical Sciences and Center for Molecular Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung, 40402, Taiwan

    Ruey-Hwang Chou

  5. Department of Biotechnology, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan

    Ruey-Hwang Chou

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  1. Cheng-Ming Peng
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  2. Hsin-Cheng Liu
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  3. Ching-Lung Hsieh
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  5. Teng-Chieh Cheng
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Correspondence to Ruey-Hwang Chou or Yi-Jui Liu.

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Peng, CM., Liu, HC., Hsieh, CL. et al. Application of a commercial single-port device for robotic single-incision distal pancreatectomy: initial experience. Surg Today 48, 680–686 (2018). https://doi.org/10.1007/s00595-018-1647-6

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  • DOI: https://doi.org/10.1007/s00595-018-1647-6

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