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Review
. 2018 Jan 17:4:13.
doi: 10.21037/jovs.2017.12.15. eCollection 2018.

Robotic vascular resections during Whipple procedure

Bassan J Allan  1 , Stephanie M Novak  1 , Melissa E Hogg  1 , Herbert J Zeh  1
Affiliations
Review

Robotic vascular resections during Whipple procedure

Bassan J Allan et al. J Vis Surg. .

Abstract

Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections. This report outlines our technique.

Keywords: Robotic-assisted; Whipple; pancreaticoduodenectomy; portovenous reconstruction; vein resection.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Port placement for robotic Whipple procedure. (R1–3, 8 mm robot ports; C, 12 mm lap port for camera; A1, 5 mm port for assistant; A2, gel mini port for assistant; M, 5 mm port for Mediflex liver retractor).
Figure 2
Figure 2
Intraoperative video of robotic pancreatic resection with tumor involvement of the SMV-PV junction. Isolation and control of all major venous vasculature. “Artery-first” approach implemented to isolate tumor to its point of vascular involvement. Transection of involved venous segment with Bovine patch reconstruction in a diamond configuration (19). PV, portal vein; SMV, superior mesenteric vein. Available online: http://asvidett.amegroups.com/article/view/22378
See this image and copyright information in PMC

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