Aberrant anatomy in robotic pancreaticoduodenectomy

Abstract

Presenter: Gabriel Rivera-Espineira MD | AdventHealth Tampa Background: Approximately 20% of the population have variant hepatic arterial anatomy. This video demonstrates the operative approach to 3 different aberrant hepatic vascular anatomy which was identified during Robotic Pancreaticoduodenectomies. Results: The first operation is of a 75 years old lady with pancreatic head IPMN and a Common Hepatic Artery which is coming off the Superior Mesenteric Artery. The second operation is of a 71 years old man with a pancreatic head adenocarcinoma who was found to have an early bifurcation of the Left and Right Hepatic Arteries with a Gastroduodenal Artery and Right Gastric Artery coming off the Right Hepatic Artery. The third operation is a 58 years old lady with a pancreatic head adenocarcinoma, who was found to have a replaced right hepatic artery coming off the Superior mesenteric artery. Conclusion: The use of the robotic platform and triple phase 1mm cuts high quality CT scan with reconstructions were crucial in identifying the aberrant anatomy pre and intraoperatively in order to avoid vascular injuries during the operation.