Robot-assisted Procedures in Pancreatic Surgery

Aim. To improve the outcomes in patients with pancreatic tumors by using of robot-assisted techniques.

Material and Methods. For the period 2009–2017 in the abdominal department №1 of Vishnevsky Institute of Surgery 93 patients with  pancreatic tumors have undergone robot-assisted surgery. There  were 17 pancreaticoduodenectomies, 49 distal pancreatectomies, 19  tumor enucleations, 6 median pancreatectomies and 2 total  duodenopancreatectomies.

Results. Time of procedures depended on their types: 400 (360; 505) min for pancreaticoduodenectomy and 210 (178; 250) min for  distal pancreatectomy. Mean blood loss for the same surgeries was  200 (150; 500) and 100 (50; 300) ml respectively. In case of tumor  enucleations and median pancreatectomies blood loss was minimal.  Conversion to laparotomy was performed in 4 cases: 2 in  pancreaticoduodenectomy, 1 in distal pancreatectomy and 1 in tumor enucleation. Postoperative complications occurred in 38 cases:  there were 35 pancreatic fistulas which were followed by hemorrhage in 6 patients.

Conclusion. Robot-assisted procedures are indicated for malignant and borderline malignant pancreatic T1–T2 staged tumors as well as  benign tumors with diameter less than 5–6 cm. Robot-assisted  technologies are not associated with significantly decreased  postoperative morbidity. Indications for robot-assisted pancreatic  surgery may be extended along learning curve.

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