Robotic Pancreatoduodenectomy for Pancreatic Head Cancer: a Case Report of a Standardized Technique

• Published in: Journal of visualized experiments no. 184
• Main Authors: Zwart, Maurice J W, Jones, Leia R, Hogg, Melissa E, Tol, Johanna A M G, Abu Hilal, Mohammad, Daams, Freek, Festen, Sebastiaan, Busch, Olivier R, Besselink, Marc G
• Format: Journal Article
• Language: English
• Published: United States 24.06.2022
• Subjects: Female; Humans; Middle Aged; Pancreas - surgery; Pancreatic Neoplasms; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy - methods; Robotic Surgical Procedures - methods; Robotics - methods
• ISSN: 1940-087X; 1940-087X
• DOI: 10.3791/62863

Robotic pancreatoduodenectomy (RPD) for pancreatic cancer is a challenging procedure. Aberrant vasculature may increase the technical difficulty. Several studies have described the safety of RPD in case of a replaced or aberrant right hepatic artery, but detailed video descriptions of the approach are lacking. This case report describes a step--by--step technical video in case of a replaced right hepatic artery. A 58-year-old woman presented with an incidental finding of a 1.7 cm pancreatic head mass. RPD was performed using the da Vinci Xi system and involves a robotic-assisted pancreatico- and hepatico-jejunostomy and open gastro-jejunostomy at the specimen extraction site. The operation time was 410 min with 220 mL of blood loss. The patient had an uncomplicated postoperative course and was discharged after 5 days. Pathology revealed a pancreatic head cancer. RPD is a feasible and safe procedure in case of a replaced hepatic artery when performed in selected patients in high-volume centers by experienced surgeons.