Int J Med Robot - Robotic central pancreatectomy with stented pancreaticogastrostomy: operative details.

Tópicos

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Resumo

CKGROUND: Central pancreatectomy (CP) is increasingly being used to treat selected lesions of the central pancreatic segment. A step-by-step technique for robotic CP is described and a literature review provided for this minimally invasive approach.METHODS: A 55-year-old woman was referred to the authors' center for the treatment of a single 4 cm lesion located at the proximal part of the pancreatic body. The da Vinci Robotic surgical system? with a five trocar technique was used. The pancreatic neck was transected using an endoscopic stapler. The pancreatic body was progressively dissected from the splenic vessels right to left and sectioned with an appropriate oncologic margin. A pancreaticogastrostomy protected by a transanastomotic external stent was constructed to the distal pancreatic stump.RESULTS: Surgery lasted 450 min (8 min docking time) with minimal blood loss. Pathology showed a 28 mm well-differentiated neuroendocrine pancreatic tumor with tumor-free resection margins. The patient was discharged home on postoperative day 15 in good condition.CONCLUSIONS: Robotic surgery can be safely used for complex pancreatic resection requiring pancreaticoenteric reconstruction. The experience reported so far is still limited but the results are encouraging; robotics shows the potential to bridge the gap between minimally invasive surgery and advanced pancreatic surgery.

Resumo Limpo

ckground central pancreatectomi cp increas use treat select lesion central pancreat segment stepbystep techniqu robot cp describ literatur review provid minim invas approachmethod yearold woman refer author center treatment singl cm lesion locat proxim part pancreat bodi da vinci robot surgic system five trocar techniqu use pancreat neck transect use endoscop stapler pancreat bodi progress dissect splenic vessel right left section appropri oncolog margin pancreaticogastrostomi protect transanastomot extern stent construct distal pancreat stumpresult surgeri last min min dock time minim blood loss patholog show mm welldifferenti neuroendocrin pancreat tumor tumorfre resect margin patient discharg home postop day good conditionconclus robot surgeri can safe use complex pancreat resect requir pancreaticoenter reconstruct experi report far still limit result encourag robot show potenti bridg gap minim invas surgeri advanc pancreat surgeri

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