First experience with robotic spleen-saving, vessel-preserving distal pancreatectomy in Singapore: a report of three consecutive cases
| Autor: | Brian K. P. Goh, Peng-Chung Cheow, Alexander Yf Chung, L.L. Ooi, Jen-San Wong, Chung-Yip Chan |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous medicine.medical_treatment 030230 surgery Patient Positioning 03 medical and health sciences Young Adult 0302 clinical medicine Pancreatectomy Robotic Surgical Procedures medicine Humans Case Series Prospective Studies Laparoscopy Prospective cohort study Singapore medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Cystic Neoplasm Surgery Pancreatic Neoplasms Pancreatic fistula 030220 oncology & carcinogenesis Female Complication business Organ Sparing Treatments Spleen Follow-Up Studies |
| Popis: | INTRODUCTION The use of laparoscopic distal pancreatectomy (LDP) has increased worldwide due to the reported advantages associated with this minimally invasive procedure. However, widespread adoption is hindered by its technical complexity. Robotic distal pancreatectomy (RDP) was introduced to overcome this limitation, but worldwide experience with RDP is still lacking. There is presently evidence that RDP is associated with decreased conversion rate and increased splenic preservation as compared to LDP. METHODS We conducted a prospective study on our initial experience with robotic spleen-saving, vessel-preserving distal pancreatectomy (SSVP-DP) between July 2013 and April 2014. RESULTS Three consecutive patients underwent attempted robotic SSVP-DP. The indications were a 2.1-cm indeterminate cystic neoplasm, 4.5-cm solid pseudopapillary neoplasm and 1.2-cm pancreatic neuroendocrine tumour. For all three patients, the procedure was completed without conversion, and the spleen, with its main vessels, was successfully conserved. The median total operation time, blood loss and postoperative stay were 350 (range 300-540) minutes, 200 (range 50-300) mL and 7 (range 6-14) days, respectively. Two patients had minor Clavien-Dindo Grade I complications (one Grade A pancreatic fistula and one postoperative ileus). One patient had a Clavien-Dindo Grade IIIa complication (Grade B pancreatic fistula requiring percutaneous drainage). All patients were well at the time of reporting after at least six months of follow-up. CONCLUSION Our preliminary experience with robotic SSVP-DP confirmed the feasibility of the procedure. |
| Databáze: | OpenAIRE |
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