Robotic Spleen-preserving Distal Pancreatectomy For Neuroendocrine Tumor

Eren Berber, MD, FACS; Emin Kose, MD; Bora Kahramangil, MD; Mustafa Donmez, MD; Husnu Aydin, MD

Product Details
Product ID: ACS-5551
Year Produced: 2018
Length: 5 min.


Patient was a 61-year-old female with multiple, incidentally detected, cystic lesions in the pancreas. Endoscopic ultrasound and biopsy were performed, revealing low grade pancreatic neuroendocrine tumor. Robotic, spleen-preserving distal pancreatectomy was planned. Patient was placed supine and the abdomen entered using an optical trocar. After placement of 4 additional trocars, diagnostic laparoscopy was performed showing no evidence of extrapancreatic disease. The robot was docked. The lesser sack was entered, and pancreas identified. Laparoscopic ultrasound demonstrated 2 lesions in the body of the pancreas. The inferior border of the pancreas was mobilized. Then, the splenic vein and artery were skeletonized and encircled by vessel loops. The pancreas was divided at the neck with a purple load linear stapler and reinforced with tissue matrix. Then, the distal pancreas was dissected off the splenic artery and vein by fine dissection. Feeding vessels were identified, tied, and divided along the dissection. The robot was undocked after completion of pancreatic dissection. The specimen was removed laparoscopically and a 10 mm JP drain was laid along the pancreatic stump. Patient was discharged on postoperative day #9 due to postoperative ileus. Final pathology showed well-differentiated, multifocal neuroendocrine tumor. Her 1 year follow up did not show any evidence of recurrence.