Central pancreatectomy - a suitable candidate for robotic surgery

Abstract

Background: In the last few decades central pancreatectomy is increasedly adopted in treatment of benign pancreatic lesions situated in the body of the pancreas, especially in young patients. With recent advances in technology, patients with these lesions could benefit from the advantages of the robotic approach. Case presentation: We present the case of a 30-years old woman investigated for epigastric pain. CT showed a 3 cm cystic tumor located in the proximal part of the pancreas body. Robotic central pancreatectomy with pancreatogastrostomy was performed. Results: Operative time was 220 minutes with minimal blood loss. The postoperative course was marked by a basal left pneumonia on postoperative day 3 treated conservatively. The patient was discharged home on postoperative day 8. Pathology showed a 30 mm well differentiated neuroendocrine tumor with free resection margins. Conclusions: Robotic systems offer several advantages compared to laparoscopy: increased and stabile tridimensional view of the operative field and articulated instruments. Robotic central pancreatectomy seems to be a suitable candidate for robotic surgery requiring delicate vascular dissection and a safe reconstruction. Although there are only few cases published in the literature so far, robotics could lead to an increased adoption of minimally invasive techniques in difficult pancreatic procedures, especially in those requiring reconstructions.