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Robotic Resection of Retropancreatic Ovarian Cancer Metastasis

Yee L. Cheah, MD; Caroline J. Simon, MD; Valena J. Wright, MD

Product Details
Product ID: ACS-5680
Year Produced: 2018
Length: 7 min.
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This is a 58-year old female with a history of ovarian cancer s/p total abdominal hysterectomy with bilateral salpingo-oopherectomy in 2010. She underwent adjuvant chemotherapy but developed a solitary retropancreatic lymph node metastasis in 2012 which was treated with radiotherapy and chemotherapy. Her disease was stable until 6 months ago, when it was noted to be enlarging on surveillance imaging. A PET-CT confirmed that this was the only spot with FDG-avidity. Her case was discussed at the Gyn-Oncology multidisciplinary Tumor Board and HepatoPancreatoBiliary Robotic Team was consulted to determine resectability. We were fortunate not to encounter much adhesions which allowed us to proceed and complete the resection robotically. The duodenum was Kocherized and the anterior and lateral surface of the IVC and aorta was exposed in the area behind the pancreatic head. Significant adhesions were encountered likely related to previous radiation treatment and the tumor was adherent to the posterior aspect of the pancreatic head and the 2 blood vessels. Meticulous dissection was performed to free the tumor without injury to surrounding structures. The right ovarian vein was noted to be inserting into the IVC just adjacent to the tumor and this was likely the route of spread from the pelvis.