Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy

Abstract

Purpose: Central pancreatectomy is a parenchyma-sparing alternative to distal pancreatectomy in patients with a benign of low-grade malignant tumor in the body of the pancreas. The aim of central pancreatectomy is to prevent postoperative life-long endocrine and exocrine insufficiency. Due to the high rate of postoperative pancreatic fistula after central pancreatectomy, many surgeons do not routinely use central pancreatectomy in patients who would be eligible. This is the first description of a standardized approach to robotic central pancreatectomy with Roux-en-Y pancreaticojejunostomy reconstruction in an adolescent. Method: We demonstrate a video of the technical approach of a robotic assisted central pancreatectomy with Roux-en-Y pancreaticojejunostomy in an adolescent. The surgery was performed using the da Vinci Xi system. Results: The case involves a 16-year-old boy with an incidental finding in the body of the pancreas. The operation time was 248 min with 20 ml blood loss. The postoperative course was uneventful. No clinically relevant pancreatic fistula or other postoperative complications occurred. Pathology assessment revealed a radically resected solid pseudo papillary tumor. Conclusion: Robotic central pancreatectomy with Roux-en-Y pancreaticojejunostomy seems feasible and can be safely applied in selected patients in experienced centers.