Robotic Pancreatic Surgery in a Community Hospital Setting: Our Initial Experience

Hetal D Patel, MD1, Rachel E Martin, MD1, Stan C Hewlett, MD, FACS2. 1Baptist Health System of Alabama, 2Princeton Surgical Specialists

Introduction

Robotic pancreatic surgery at a community hospital is viable and produces safe operative outcomes. A current trend in surgery is to utilize a robotic surgical system for complex abdominal operations. This is not limited to academic institutions. The use of the robot allows for more precise manipulation of instruments and tissue. The 3-D, HD visualization of the console allows for safer dissection while providing an ergonomic advantage to the surgeon. This technology has been slowly integrated into general surgery, but is now used for virtually every type of surgery while maintaining safety and improving patient satisfaction. In our community hospital, its role has now expanded to pancreatic surgery. Robotics promises to facilitate the transition of surgical pancreatic care from traditional open to minimally invasive surgery. There is a relative void in the surgical literature regarding robotic pancreatic surgery which is becoming more popular in many centers across North America.

Methods

A retrospective chart review of the initial forty-two robotic assisted pancreatic procedures were examined. These encompassed any type of pancreatic resection for suspected malignancy including pancreatoduodenectomy and distal pancreatectomy with or without splenectomy. The length of stay, operative blood loss, leak rates, lymph node count, successful oncological resection and a conversion to open procedure were examined. Data extracted and means reported.

Results

Since late 2010 there were over 40 patients that underwent robotic pancreas surgery. All were deemed resectable by preoperative imaging studies. Of these cases, there were a few unresectable at time of surgery secondary to extrapancreatic disease and instead received palliative bypass or no further operation. Of the remaining cases, the results were also favorable.

Conclusions

Robotic pancreatic surgery offers patients reduced operative blood loss with acceptable morbidity and mortality while providing the benefits of minimally invasive surgery.

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