Robotic Left-Subtotal Splenopancreatectomy for a Pancreatic Neck Carcinoma Compressing the Splenomesenteric Confluence

Matteo Palmeri, MD

Product Details
Product ID: ACS-6150
Year Produced: 2020
Length: 7 min.


Background: The last evolution of robotic system, the da Vinci Xi, has some intrinsic technical improvements that allow an easier and faster surgery in challenging procedures, such as pancreatic resections. We present a case of a left subtotal splenopancreatectomy for a solid mass of the body of the pancreas, in contact with the splenomesenteric confluence, performed with the da Vinci Xi.Methods: A 78years old man with an incidental finding of a lesion of the neck of the pancreas was operated with the da Vinci Xi platform. The preoperative CT scan confirmed the location of the lesion just above the splenomesenteric confluence. For the procedure, we used the upper quadrants trocars disposition suggested by Intuitive.Results: We performed the subtotal splenopancreatectomy totally robotic, with careful isolation and dissection of the lesion from the splenoportalmesenteric confluence, which was compressed but not infiltrated. Pancreas was transected at gastroduodenal artery level. The procedure was completed in 350 minutes and no conversion or intraoperative complications were recorded. The postoperative course was uneventful and the patient was discharged on the 7th postoperative day.Conclusions: The da Vinci Xi gives some advantages in pancreatic resections, allowing to perform challenging procedures with a minimally invasive technique, such as in cases of lesions close to the vessels. These advantages could improve the widespread of minimally invasive surgery for the treatment of pancreatic disease.