• 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

Robotic-Assisted Versus Laparoscopic Distal Pancreatectomy at a High Volume, Minimally Invasive Center

William B Lyman, MD, Michael Passeri, MD, Amit Sastry, MD, Allyson Cochran, MSPH, David A Iannitti, MD, FACS, Dionisios Vrochides, MD, PhD, FACS, FRCSC, Erin H Baker, MD, FACS, John B Martinie, MD, FACS. Carolinas Medical Center

Background: The robotic-assisted approach to distal pancreatectomy has gained popularity over the past decade with most studies showing comparable results to those of laparoscopic distal pancreatectomy.  One limitation to previous studies is that the majority of sampled data is from institutions which still perform a relatively high percentage of open procedures (most well over 50%).  In this study we present a comparison of robotic-assisted and laparoscopic distal pancreatectomies at a high volume center where approximately 70% of distal pancreatectomies are performed in minimally invasive fashion.

Methods: We performed a retrospective analysis of prospectively recorded data from a REDCap™ database to identify all minimally invasive distal pancreatectomies from January 2008-June 2017 (n=250).  One patient was excluded for undergoing simultaneous HIPEC therapy leaving our total number of minimally invasive distal pancreatectomies at 249.  All pathologic margins were analyzed according to the Leeds Pathology Protocol (LEEPP) which results in higher rates of margin positivity than traditional neck margin evaluation.  Statistical analysis was performed using STATA® software using a combination of Wilcoxon rank-sum and Pearson’s chi-squared tests.

Results: Of the 249 minimally invasive distal pancreatectomies performed at our institution, 135 were performed laparoscopically, and 114 were performed with robotic-assistance.  Females were more likely to undergo a robotic-assisted procedure (p=0.034).  Additional demographic variables and indications for procedure were similar between groups [Table 1].  Overall, 22.9% of patients underwent distal pancreatectomy for adenocarcinoma. Splenic preservation occurred more often in the robotic-assisted group (p<0.001), and operative time was shorter in the laparoscopic group (p<0.001).  Additional outcomes were similar between groups [Table 2].  Of the 58 total patients with adenocarcinoma, a greater number of lymph nodes was evaluated in the robotic cohort (p=0.039).  Additional outcomes in patients with adenocarcinoma were similar [Table 3].

Conclusions: At a high volume minimally invasive center, robotic-assisted and laparoscopic approaches to distal pancreatectomy are reasonable for both benign and malignant disease.  While splenic preservation rate is higher in the robotic-assisted group, we are unable to retrospectively determine intention to preserve the spleen preoperatively.  While operating room time is longer in the robotic-assisted group, this may be an artifact of higher splenic preservation rates.  The greater number of average lymph nodes evaluated for adenocarcinoma in the robotic-assisted group may suggest a more thorough lymph node dissection in the robotic group.  In the hands of highly skilled minimally invasive surgeons, both approaches produce similar results with a low overall conversion rate (6.0%).


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 88046

Program Number: S062

Presentation Session: Liver/Pancreas Session

Presentation Type: Podium

39

Share this:

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

Related

« Return to SAGES 2018 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