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Case Reports
. 2020 Aug;24(8):1920-1921.
doi: 10.1007/s11605-020-04603-9. Epub 2020 Apr 20.

Tangential Venous Resections during Robotic-Assisted Pancreaticoduodenectomy: the Results of a Case Series (with Video)

Marco Vito Marino  1   2 , Mario Adelfio Latteri  3 , Ali Ahmad  4
Affiliations
Case Reports

Tangential Venous Resections during Robotic-Assisted Pancreaticoduodenectomy: the Results of a Case Series (with Video)

Marco Vito Marino et al. J Gastrointest Surg. 2020 Aug.

Abstract

Introduction: Despite the potential advantages in terms of microdissection and microsuturing capabilites, the robotic approach for borderline resectable pancreatic cancer is scarcely reported.

Methods: We report our technique for a robotic-assisted pancreaticoduodenectomy with tangential Portal/ Superior Mesenteric Vein resection/reconstruction (RPD PV/SMV).We also compared the surgical outcomes of eight consecutive patients undergoing RPD PV/SMV with that of sixty patients who underwent robotic-assisted pancreaticoduodenectomy (RPD) in the same period of time.

Results: A total of eight consecutive patients underwent RPD PV/SMV. We observed an increased estimated blood loss (550 vs 280 mL, p = 0.003) and operative time (438 vs 350 min, p = 0.002) in the RPD PV/SMV group of patients compared with RPD group, whereas the complication rate (28% vs 31%, p = 0.726) was similar. No venous-congestion related complications were observed in the postoperative course. The median length of hospital stay was similar in the RPD group in comparison to that in the RPD PV/SMV group (10 vs 13 range 6-19 days, p = 0.313).

Conclusion: RPD PV/SMV is a challenging operation. It is associated with higher operative time and increased estimated blood loss in comparison to standard RPD.

Keywords: Robotic-assisted pancreaticoduodenectomy; Vascular resection; Video technique.

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References

    1. Croome KP, Farnell MB, Que FG, Reid-Lombardo KM, Truty MJ, Nagorney DM, Kendrick ML. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg. 2015 Jan;19(1):189-94; discussion 194. https://doi.org/10.1007/s11605-014-2644-8
    1. Ohgi K, Yamamoto Y, Sugiura T, Okamura Y, Ito T, Ashida R et al. Is Pancreatic Head Cancer with Portal Venous Involvement Really Borderline Resectable? Appraisal of an Upfront Surgery Series. Ann Surg Oncol. 2017 Sep;24(9):2752-276 - DOI
    1. Marino MV, Podda M, Pisanu A, di Saverio S, Fleitas MG. Robotic-assisted Pancreaticoduodenectomy: Technique Description and Performance Evaluation After 60 Cases [published online ahead of print, 2020 Jan 7]. Surg Laparosc Endosc Percutan Tech. 2020; https://doi.org/10.1097/SLE.0000000000000751 .

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