OP 81. Robotic Pancreatic Surgery, Experience and Literature Review

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G. Ceccarelli, A Biancafarina, E. Andolfi, A Bartoli, A Patriti

Chair(s): György Wéber, Mehmet Fatih Can & Norbert Németh

9:00 - 9:10h at Pest Room (C)

Categories: Oral Session, Robotic and Minimal Invasive Surgery

Session: Oral Session IX - Robotic and Minimal Invasive Surgery

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Background
Minimally invasive surgery of the pancreas represents one of the most challenging surgical field. Robotic surgery allows to overcame many laparoscopic limitations.

Material and Methods
A sistematic review and retrospective personal experince analysis of 48 patients performed between 2006 and 2013, was made to analyse results of robotic pancreatic procedures.

Result
From March 2006 to September 2013, 48 patients underwent robotic-assisted surgery for different pancreatic diseases by the same equipe of surgeons. The average age was 75.2 years (range 47 – 83 years). Distal pancreatectomy were 21 (13 spleen preserving); 18 duodenopancreatectomies (1 total pancreatectomy); 8 enucleoresections; 1 central pancreatectomy. Diagnosis was: 11 pancreatic ductal adenocarcinoma, 8 ampullary adenocarcinama, 11 neuroendocrine tumors, 9 cistic tumors, 5 IPMNs, 2 crohonic pancreatitis, 1 renal metastasis, 1 leyomiosarcoma. Mean operating time was 175 min for distal pancreatectomy and 380 min (320-470) for duodenopancreatectomy. There were 2 conversions to open surgery. Mean length of stay was 7.2 days (3–15 days) for distal pancreatectomy; 9.4 days (7-31 days) for duodenopancraetectomy . The postoperative morbidity rate was 21% and the mortality rate was 2.,08% (1 patient)

Conclusion
Robot-assisted pancreatic surgery is increasing. Bleeding loss and fistula rate comparing minimally invasive and open procedures, are the most interesting aspects to investigate. The magnified view and the surgical precision allowed by robotic technology, especially to perform the pancreato-jejunostomy are a reason for the lower mobidity rate in robotic technique. Duodenopancreatectomy is feasible and safe but it takes a longer operative time.