Robotic Pancreatoduodenectomy for Pancreatic Head Cancer: a Case Report of a Standardized Technique.

Journal: Journal of visualized experiments : JoVE
Published Date:

Abstract

Robotic pancreatoduodenectomy (RPD) for pancreatic cancer is a challenging procedure. Aberrant vasculature may increase the technical difficulty. Several studies have described the safety of RPD in case of a replaced or aberrant right hepatic artery, but detailed video descriptions of the approach are lacking. This case report describes a step--by--step technical video in case of a replaced right hepatic artery. A 58-year-old woman presented with an incidental finding of a 1.7 cm pancreatic head mass. RPD was performed using the da Vinci Xi system and involves a robotic-assisted pancreatico- and hepatico-jejunostomy and open gastro-jejunostomy at the specimen extraction site. The operation time was 410 min with 220 mL of blood loss. The patient had an uncomplicated postoperative course and was discharged after 5 days. Pathology revealed a pancreatic head cancer. RPD is a feasible and safe procedure in case of a replaced hepatic artery when performed in selected patients in high-volume centers by experienced surgeons.

Authors

  • Maurice J W Zwart
    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Leia R Jones
    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Melissa E Hogg
    Division of Surgical Oncology, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Johanna A M G Tol
    Department of Surgery, Amsterdam, the Netherlands, Amsterdam UMC, location University of Amsterdam; Cancer Center Amsterdam, the Netherlands.
  • Mohammad Abu Hilal
    Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza.
  • Freek Daams
    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, VU University, Amsterdam, The Netherlands.
  • Sebastiaan Festen
    Department of Surgery, OLVG, Amsterdam, the Netherlands.
  • Olivier R Busch
    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
  • Marc G Besselink
    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. m.g.besselink@amsterdamumc.nl.