Introduction: We describe a robotic assisted, minimally invasive approach to the excision of a large (8 cm) pancreatic head cystic mass. The technique is described and detailed through this video session. This is the first documented successful robotic assisted resection of a pancreatic head cystic neoplasm.

Methods: The robotic assisted resection was carried out by utilizing the da Vinci-S(r) surgical system by Intuitive Surgical. The dissection was carried out with robotic radiofrequency ablative dissectors for coagulation and robotic scissor sharp dissection instruments. Further assistance was carried out via an assist port for suction and stapling. After mobilization, the cyst was excised off the pancreatic head with a normal cuff of pancreatic tissue using linear stapling devices (US surgical).

Results: Pathologic examination revealed that the cyst was excised completely with a normal cuff of pancreatic tissue. The patient's bowel function returned postoperative day number 2, and she was subsequently discharged days later. This reports the successful utilization of a robotic, minimally invasive approach to the resection of a proximal pancreatic cystic neoplasm.

Conclusion: With experience, minimally invasive, robotic assisted procedures can be carried out safely and successfully in proximal pancreatic lesions. As success mounts with this approach, the morbidity of cystic pancreatic neoplasm excisions may be reduced from the standard subcostal approach used currently.