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Robot-Assisted Spleen-Preserving Laparoscopic Distal Pancreatectomy

Abstract

Background

Spleen-preserving laparoscopic distal pancreatectomy would be an ideal approach for benign and borderline malignant tumors in the distal pancreas.1 However, this procedure requires advanced surgical experience and technique because of the disadvantages of conventional laparoscopic surgery.2

Methods

A 35-year-old female patient visited our institution because of a growing pancreatic mass during follow-up. A preoperative image study showed a cystic tumor of about 3.0 × 2.5 cm in size in the body of the pancreas. Under the impression of a growing serous cystic tumor of the pancreas, she was scheduled to undergo robot-assisted spleen-preserving laparoscopic distal pancreatectomy.

Results

Under general anesthesia, the patient was placed in the supine position with her head and left side elevated. A total of five ports were used. Among them, one 12-mm port was placed for the assistant surgeon’s intervention during the procedure. Stable 3-dimensional operative image, endo-wrist function of the instruments, and no tremor were thought to be very helpful for fine dissection of the pancreas from splenic vessels. The total operation time was 300 min, and the estimated intraoperative blood loss was 380 ml. No transfusion was required. The patient’s postoperative recovery was uneventful. She was able to go home on the 6th postoperative day without a drain.

Conclusions

The unique characteristics of a robotic surgical system were thought to be very helpful during the spleen-preserving laparoscopic distal pancreatectomy.2 6 However, cost is one of the main obstacles for the procedure’s popular clinical practice.2

References

  1. 1.

    Lanfranco AR, Castellanos AE, Desai JP, Meyers WC. Robotic surgery: a current perspective. Ann Surg. 2004;239:14–21.

  2. 2.

    Kang CM, Chi HS, Hyeung WJ, Kim KS, Choi JS, Lee WJ, et al. The first Korean experience of telemanipulative robot-assisted laparoscopic cholecystectomy using the da vinci system. Yonsei Med J. 2007;48:540–5.

  3. 3.

    Kang CM, Chi HS, Kim JY, Choi GH, Kim KS, Choi JS, et al. A case of robot-assisted excision of choledochal cyst, hepaticojejunostomy, and extracorporeal Roux-en-y anastomosis using the da Vinci surgical system. Surg Laparosc Endosc Percutan Tech. 2007;17:538–41.

  4. 4.

    Giulianotti PC, Sbrana F, Bianco FM, Addeo P, Caravaglios G. Robot-assisted laparoscopic middle pancreatectomy. J Laparoendosc Adv Surg Tech A. 2010;20:135–9.

  5. 5.

    Giulianotti PC, Sbrana F, Bianco FM, Elli EF, Shah G, Addeo P, et al. Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc. 2010;24:1646–57.

  6. 6.

    Kang CM, Kim DH, Lee WJ. Ten years of experience with resection of left-sided pancreatic ductal adenocarcinoma: evolution and initial experience to a laparoscopic approach. Surg Endosc. 2010;24:1533–41.

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Author information

Correspondence to Chang Moo Kang MD.

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Supplementary material 1 (WMV 92679 kb)

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Choi, S.H., Kang, C.M., Lee, W.J. et al. Robot-Assisted Spleen-Preserving Laparoscopic Distal Pancreatectomy. Ann Surg Oncol 18, 3623 (2011). https://doi.org/10.1245/s10434-011-1816-y

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Keywords

  • Pancreatic Ductal Adenocarcinoma
  • Choledochal Cyst
  • Splenic Vessel
  • Conventional Laparoscopic Surgery
  • Vinci Surgical System