Robot-assisted Procedures in Pancreatic Surgery

Abstract

Aim . To improve the outcomes in patients with pancreatic tumors by using of robot-assisted techniques. Material and Methods . For the period 2009–2017 in the abdominal department №1 of Vishnevsky Institute of Surgery 93 patients with pancreatic tumors have undergone robot-assisted surgery. There were 17 pancreaticoduodenectomies, 49 distal pancreatectomies, 19 tumor enucleations, 6 median pancreatectomies and 2 total duodenopancreatectomies. Results. Time of procedures depended on their types: 400 (360; 505) min for pancreaticoduodenectomy and 210 (178; 250) min for distal pancreatectomy. Mean blood loss for the same surgeries was 200 (150; 500) and 100 (50; 300) ml respectively. In case of tumor enucleations and median pancreatectomies blood loss was minimal. Conversion to laparotomy was performed in 4 cases: 2 in pancreaticoduodenectomy, 1 in distal pancreatectomy and 1 in tumor enucleation. Postoperative complications occurred in 38 cases: there were 35 pancreatic fistulas which were followed by hemorrhage in 6 patients. Conclusion. Robot-assisted procedures are indicated for malignant and borderline malignant pancreatic T1–T2 staged tumors as well as benign tumors with diameter less than 5–6 cm. Robot-assisted technologies are not associated with significantly decreased postoperative morbidity. Indications for robot-assisted pancreatic surgery may be extended along learning curve.