Robot-Assisted Pancreaticoduodenectomy Using the Anterior Superior Mesenteric Artery-First Approach for Pancreatic Cancer

Background The superior mesenteric artery (SMA)-first approach for pancreatic cancer (PC) is common surgical technique in pancreaticoduodenectomy. To date, few studies have reported SMA-first approach in robot-assisted pancreaticoduodenectomy (RPD). Herein, we present the anterior SMA-first approach...

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Published inAnnals of surgical oncology Vol. 31; no. 13; pp. 8741 - 8743
Main Authors Takagi, Kosei, Fuji, Tomokazu, Yasui, Kazuya, Yamada, Motohiko, Nishiyama, Takeyoshi, Nagai, Yasuo, Kanehira, Noriyuki, Fujiwara, Toshiyoshi
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.12.2024
Springer Nature B.V
Subjects
Chemotherapy
Dissection
Jejunum
Medicine
Medicine & Public Health
Oncology
Pancreatic cancer
Pancreatic Tumors
Pancreaticoduodenectomy
Robotic surgery
Surgery
Surgical Oncology
Tumors
Pancreatic cancer
Superior mesenteric artery approach
Robotic pancreaticoduodenectomy
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Summary:Background The superior mesenteric artery (SMA)-first approach for pancreatic cancer (PC) is common surgical technique in pancreaticoduodenectomy. To date, few studies have reported SMA-first approach in robot-assisted pancreaticoduodenectomy (RPD). Herein, we present the anterior SMA-first approach for PC during RPD. Patient and Method A 75-year-old man with resectable PC underwent RPD after neoadjuvant chemotherapy. As pancreatic head tumor contacted with the superior mesenteric vein (SMV), the anterior SMA approach was applied. After the mesenteric Kocher maneuver, the jejunum was divided and the left side of the SMA was dissected. Subsequently, the anterior plane of the SMA was dissected. Following the division of branches from the mesenteric vessels, the SMA was taped, and the circumferential dissection around the SMA was performed to detach the pancreatic neck from the SMA completely. Finally, the dissection between the SMV and the tumor was performed under vascular control to remove the specimen. Conclusions The anterior SMA-first approach can be optional in patients with PC undergoing RPD. This unique approach allows for the circumferential dissection around the SMA during RPD.
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ISSN:1068-9265
1534-4681
1534-4681
DOI:10.1245/s10434-024-16305-6