Robotic Spleen-preserving Distal Pancreatectomy

Chang Moo Kang, Sung Hoon Choi, Jin Hong Im, Ho Kyoung Hwang, Woo Jung Lee. Yonsei University College of Medicine, Seoul, Korea


The advanced and delicate laparoscopic techniques are usually required for safe and successful laparoscopic spleen-preserving distal pancreatectomy. Unique characteristics of robotic surgical system are thought to be useful for this minimally invasive procedure.

Materials and Methods
From September 2007 to May 2011, patients who underwent robotic spleen-preserving distal pancreatectomy for benign and borderline malignant tumor of the pancreas were retrospectively reviewed. Perioperative clinicopathologic surgical outcomes were evaluated.

Twenty-three patients were attempted for robotic spleen-preserving distal pancreatectomy, and 22 patients (95.7%) could intentionally save the spleen either by splenic vessels-conservation (SVC; 17, 73.9%), or by splenic vessels-sacrifice (SVS; 5, 21.7%). Seven patients were male and 16 were female with age, 43.2±15.2 years. Body mass index was check as 23.1±3.1 Kg/m2. Pathologic diagnosis of the resected pancreatic tumor included MCT in 6 patients, SCT in 5, SPT in 4, IPMT in 3, NET in 3, and other benign conditions (intrapancreatic accessory spleen and chronic pancreatitis) in 2. Tumor size was 3.2±1.5 cm in diameter, and length of resected pancreas was 8.4±2.4cm. Operation time was 398.9±166.3 min, but it gradually decreased as experiences were accumulated (Rsq=0.223, p=0.023). Estimated intraoperative blood loss was 361.3±360.1 ml, and intraoperative transfusion was done in 4 patients (17.4%). Soft diet was given on 1.2±0.4 days, postoperatively, and length of hospital stay was 7.0±2.4 days, postoperatively. Clinically relevant postoperative pancreatic fistula was noted in 2 patients (8.6%), but could be successfully managed conservatively.

Conclusion: Robotic surgical system is thought to be beneficial for improving spleen-preserving rate in laparoscopoic distal pancreatectomy. However, its expensive cost is great obstacle for popular clinical use of this surgical system.

Session Number: SS22 – Robotics
Program Number: S127

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