Review of minimally invasive pancreas surgery and opinion on its incorporation into low volume and resource poor centres.

Autor:	Cawich SO; Clinical Surgical Sciences, University of the West Indies, Tunapuna 331333, Trinidad and Tobago. socawich@hotmail.com., Kluger MD; Department of Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY 10032, United States., Francis W; Department of Surgery, University of the West Indies, Nassau N-1184, Bahamas., Deshpande RR; Department of Surgery, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom., Mohammed F; Department of Clinical Surgical Sciences, University of the West Indies, Tunapuna 331333, Trinidad and Tobago., Bonadie KO; Department of Surgery, Health Service Authority, Georgetown 915 GT, Cayman Islands., Thomas DA; Department of Clinical Surgical Sciences, University of the West Indies, Tunapuna 331333, Trinidad and Tobago., Pearce NW; Department of Surgery, Southampton General Hospital, Southampton SO16 6YD, United Kingdom., Schrope BA; Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY 10032, United States.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal surgery [World J Gastrointest Surg] 2021 Oct 27; Vol. 13 (10), pp. 1122-1135.
DOI:	10.4240/wjgs.v13.i10.1122
Abstrakt:	Pancreatic surgery has been one of the last areas for the application of minimally invasive surgery (MIS) because there are many factors that make laparoscopic pancreas resections difficult. The concept of service centralization has also limited expertise to a small cadre of high-volume centres in resource rich countries. However, this is not the environment that many surgeons in developing countries work in. These patients often do not have the opportunity to travel to high volume centres for care. Therefore, we sought to review the existing data on MIS for the pancreas and to discuss. In this paper, we review the evolution of MIS on the pancreas and discuss the incorporation of this service into low-volume and resource-poor countries, such as those in the Caribbean. This paper has two parts. First, we performed a literature review evaluating all studies published on laparoscopic and robotic surgery of the pancreas. The data in the Caribbean is examined and we discuss tips for incorporating this operation into resource poor hospital practice. Low pancreatic case volume in the Caribbean, and financial barriers to MIS in general, laparoscopic distal pancreatectomy, enucleation and cystogastrostomy are feasible operations to integrate in to a resource-limited healthcare environment. This is because they can be performed with minimal to no consumables and require an intermediate MIS skillset to complement an open pancreatic surgeon's peri-operative experience. Competing Interests: Conflict-of-interest statement: There are no conflicts of interest reported for any of the authors. (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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