Spleen Preserving Distal Pancreatectomy and Lymph Node Dissection for Pancreatic G1 Adenocarcinoma

Giuseppe Spinoglio, MD, FACS

Product Details
Product ID: ACS-6159
Year Produced: 2020
Length: 10 min.


Distal pancreatectomy (DP) with lymph node dissection and "en bloc" splenectomy is the best surgical option for pancreatic adenocarcinoma of the body and tail. Preservation of the spleen, which is associated with a reduced postoperative morbidity, has been advocated in patients with benign lesions and some low-grade cancers especially in fragile patients. Although feasible, laparoscopic spleen preserving distal pancreatectomy (SP-DP) is a challenging and technical demanding operation. Use of the da Vinci Xi system has been proven to overcome the limits and difficulties of this operation. The video presents relevant surgical steps of a robotic SP-DP performed for a 15 mm G1 adenocarcinoma of the body of the pancreas in a 77 yrs-old woman with severe cardiovascular comorbidities (previous aortic vascular graft for ascending aortic dissection complicated with atrial fibrillation). Two technical key points such as regional lymphadenectomy (station 8-9-11p-11d-10) and splenic vessel dissection are presented in details. In addition the possibility of using the near-infrared (NIR) vision facilitates vascular anatomy identification. In conclusion we believe that robotic approach facilitates performing a SP-DP and should be always considered when this operation is indicated.