Pancreaticoduodenectomy with assistance of robotic operation system for pancreatic head cancer

Abstract

Objective To investigate the clinical application value of pancreaticoduodenectomy with the assistance of robotic operation system for pancreatic head cancer. Methods Clinical data of 38 patients with pancreatic head cancer undergoing pancreaticoduodenectomy using Da Vinci Si robotic system in Shanghai Ruijin Hospital from May 2010 to April 2014 were analyzed retrospectively. There were 25 males and 13 females with the mean age of (59±10) years old. The informed consents of all patients were obtained and the ethical committee approval was received. Three robotic exclusive Trocars, 1 camera Trocar and 1 assistant Trocar were inserted using 5-port approach and the robotic arms were inserted. Pancreaticoduodenectomy was performed under the assistance of robotic system. The perioperative situation including operation time, intraoperative blood loss, operation, postoperative complication and survive were observed. Results All the operations of 38 cases were finished successfully with radical (R0) resection rate 97% (37/38), R1 resection rate 3% (1/38) and the median operation time 413(210-520)min, intraoperative blood loss 320(50-1 100)ml, lymphnode clearance number 15(2-24), postoperative hospital stay 20(7-36)d. The incidence of postoperative complication was 42% (16/38) including pancreatic fistula (n=8), biliary fistula (n=2), postoperative infection (n=6). The postoperative survival time was 25(3-42) months and disease-free survival time was 14(5-28) months. Conclusion Pancreaticoduodenectomy with the assistance of robotic operation system is safe and feasible for resecting pancreatic head cancer. Key words: Pancreatic neoplasms; Pancreaticoduodenectomy; Da Vinci Si robotic system; Treatment outcome; Postoperative complications; Lymph node excision