Abstract
Introduction
Despite the potential advantages in terms of microdissection and microsuturing capabilites, the robotic approach for borderline resectable pancreatic cancer is scarcely reported.
Methods
We report our technique for a robotic-assisted pancreaticoduodenectomy with tangential Portal/ Superior Mesenteric Vein resection/reconstruction (RPD PV/SMV).We also compared the surgical outcomes of eight consecutive patients undergoing RPD PV/SMV with that of sixty patients who underwent robotic-assisted pancreaticoduodenectomy (RPD) in the same period of time.
Results
A total of eight consecutive patients underwent RPD PV/SMV. We observed an increased estimated blood loss (550 vs 280 mL, p = 0.003) and operative time (438 vs 350 min, p = 0.002) in the RPD PV/SMV group of patients compared with RPD group, whereas the complication rate (28% vs 31%, p = 0.726) was similar. No venous-congestion related complications were observed in the postoperative course. The median length of hospital stay was similar in the RPD group in comparison to that in the RPD PV/SMV group (10 vs 13 range 6-19 days, p = 0.313).
Conclusion
RPD PV/SMV is a challenging operation. It is associated with higher operative time and increased estimated blood loss in comparison to standard RPD.
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References
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Marino MV, Podda M, Pisanu A, di Saverio S, Fleitas MG. Robotic-assisted Pancreaticoduodenectomy: Technique Description and Performance Evaluation After 60 Cases [published online ahead of print, 2020 Jan 7]. Surg Laparosc Endosc Percutan Tech. 2020; https://doi.org/10.1097/SLE.0000000000000751.
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Highlights
• The minimally invasive approach for borderline resectable pancreatic cancer is scarcely reported.
• Robotic pancreaticoduodenectomy with type I venous resection (SMV/PV) is safe and feasible in well-selected cases and in experienced hands.
• Robotic pancreaticoduodenectomy with SMV/PV resection is associated with longer operative time and increased estimated blood loss.
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Marino, M.V., Latteri, M.A. & Ahmad, A. Tangential Venous Resections during Robotic-Assisted Pancreaticoduodenectomy: the Results of a Case Series (with Video). J Gastrointest Surg 24, 1920–1921 (2020). https://doi.org/10.1007/s11605-020-04603-9
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DOI: https://doi.org/10.1007/s11605-020-04603-9