• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Laparoscopic Robotic Assisted Whipple: Early Results of a Novel Technique and Comparison with the Standard Open Procedure

Matthew Walsh, MD, Sri Chalikonda, MD, Juan Ramon Aguilar Saavedra, MD, Gregory Lentz, PhD, John Fung, MD. Cleveland Clinic Fundation

Background: Since the introduction of minimally invasive surgery, surgeons have sought to optimize the efficiency and safety of these techniques. Recently, robotic assistance devices have been employed in conjunction with standard laparoscopic techniques to further refine minimally invasive surgery. The advantages of the laparoscopic and robotic approach to Whipple procedure are well documented, but any added safety or efficacy of laparoscopic robotic assisted surgery has not been demonstrated in the literature. In this series we compare the outcomes of Whipple procedure utilizing the laparoscopic robotic-assisted approach with its conventional open counterpart.
Methods: From March 2009 to August 2010, 25 minimally invasive Whipple resections were performed by a two pancreaticobiliary trained surgeons, compared with 25 open Whipples performed at the Cleveland Clinic Fundation. All resections were performed either using standard laparoscopic robotic-assisted approach using the da Vinci Robotic Surgical system (Intuitive Surgical, Sunnyvale, CA) or open classic Whipple. Retrospective statistical analysis of a prospectively collected group of patients was performed.
Results: Twenty five patients underwent Whipple procedure using a novel laparoscopic robotic-assisted approach and twenty five patients underwent open classical Whipple. Average age was 63 and 62 years in laparoscopic robotic assisted and open groups (p=0.33). Average BMI was (24 vs 26 p=0.19), Symtoms were present in (60% vs 64% p=0.38), and ASA score was (ASA 2 50%, ASA 3 45%, ASA 4 5% vs ASA 2 31%, ASA 3 69%) for the laparoscopic robotic assisted and open group respectively.. Indications included, adenocarcinoma (44% and 44%), IPMN (16% and 16%), and other (40% and 40%) in the laparoscopic robotic assisted and the open groups respectively. There was one perioperative death in the laparoscopic robotic assisted group . Overall morbidity, including wound infection, was 32% in laparoscopic robotic assisted group and 44%% in the open group (p=0.19) . Intraoperative factors including blood loss (537 vs 840 ml p=0.16), operative time (488 vs 364 min p=0.0009), in laparoscopic robotic assisted and open groups respectively. Conversion rate was 12% (3) in laparoscopic robotic assisted group. Reinterventions were performed in 8% and 24% in the laparoscopic robotic assisted and open groups respectively (p=0.064). Length of hospital stay was 10 days in the laparoscopic robotic assisted versus 14 days in the open group (p=0.031). Median tumor size was (3.33 vs 3.18 p=0.40), nodes examined (13 vs 12.6 p=0.44), positive margins (0% vs 12% p=0.041) in the laparoscopic robotic assisted and open groups respectively.
Conclusions: This is the only comparison of a novel laparoscopic robotic-assisted approach with the gold standard conventional open approach for Classic Whipple to date in the literature. Our data indicates a significant reduction in length of hospital stay in those patients undergoing laparoscopic robotic-assisted resection versus a conventional open approach. These data suggest equivalent intraoperative factors such as blood loss, and morbidity to open laparotomy. In summary, we find that this laparoscopic robotic-assisted Whipple is a safe and efficacious alternative to the conventional open approach.


Session: SS18
Program Number: S108

1,236

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2011 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons