Robot-assisted spleen-preserving distal pancreatectomy in a 14-year-old patient with solid pseudopapillary neoplasm

Abstract

Robotic pancreatic surgery in pediatric patients has been an area of debate due to safety and feasibility secondary to technical difficulties, such as decreased abdominal space and lack of experience. Herein, we report a 14-year-old male patient referred to our unit due to an incidentally detected pancreatic mass located in the tail of the pancreas. Preoperative radiological assessment revealed a solid pseudopapillary neoplasm, which was later confirmed by fine-needle aspiration biopsy. Robot-assisted spleenpreserving distal pancreatectomy (Kimura procedure) was performed using the da Vinci Xi robotic system. The operation lasted 4 h and 45 min without significant blood loss. The patient recovered without intensive care unit stay. Postoperative pancreatic fistula formation was not present, and the patient was discharged on the sixth postoperative day. Robotic pancreatic surgery can be safely performed in selected patient groups without any complications. A shorter convalescence period will result in shorter return to normal daily activities. Although initial reports present feasibility and safety, further studies must be conducted.