| Title |
Robotic total pancreatectomy with splenectomy: technique and outcomes
|
|---|---|
| Published in |
Surgical Endoscopy, December 2017
|
| DOI | 10.1007/s00464-017-6003-1 |
| Pubmed ID | |
| Authors |
Ioannis T. Konstantinidis, Zeljka Jutric, Oliver S. Eng, Susanne G. Warner, Laleh G. Melstrom, Yuman Fong, Byrne Lee, Gagandeep Singh |
| Abstract |
Robotic total pancreatectomy (TP) represents a minimally invasive approach to a major intra-abdominal operation. Its utility, technique, and outcomes are evolving. In this video, we describe a systematic approach to a robotic total pancreatectomy performed for multifocal intraductal papillary mucinous neoplasm (IPMN). Additionally, we reviewed the National Cancer Database (NCDB) to examine the outcomes of robotic TP compared to laparoscopic and open TP between 2010 and 2014. The patient is a 61-year-old female who was diagnosed with multifocal IPMN. A total of 6 robotic ports were placed and the da Vinci Xi robotic system was used with the patient supine. The approach entailed as follows: (1) Diagnostic laparoscopy; (2) Entry into the lesser sac; (3) Division of the short gastric vessels; (4) Exposure and dissection of the inferior pancreas border; (5) Dissection and transection of the splenic artery; (6) Mobilization of the pancreas tail/spleen; (7) Exposure of the splenic vein-superior mesenteric vein confluence; (8) Kocher maneuver; (9) Release of the ligament of Treitz and transection of the proximal jejunum; (10) Transection of the distal stomach; (11) Portal lymphadenectomy; (12) Dissection and transection of the gastroduodenal artery; (13) Superior mesenteric vein exposure/dissection of the uncinate process; (14) Hepaticojejunostomy; (15) Cholecystectomy; and (16) Gastrojejunostomy. NCDB database review of 73 patients who underwent robotic TP revealed similar rates of margin negative resections and retrieved lymph nodes between robotic, laparoscopic, and open TP, whereas robotic and laparoscopic TP were associated with shorter in-hospital stay and reduced mortality at 30 and 90 days compared to open TP. Overall median survival of pancreatic adenocarcinoma patients who underwent TP was similar between robotic, laparoscopic, and open approaches. Robotic total pancreatectomy with splenectomy offers a minimally invasive approach to a major abdominal operation and is feasible in a stepwise, reproducible technique. It is associated with improved postoperative outcomes and equivalent oncologic outcomes compared to open TP. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 6 | 13% |
| Researcher | 5 | 10% |
| Student > Ph. D. Student | 5 | 10% |
| Other | 4 | 8% |
| Student > Master | 3 | 6% |
| Other | 7 | 15% |
| Unknown | 18 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 38% |
| Environmental Science | 2 | 4% |
| Agricultural and Biological Sciences | 2 | 4% |
| Unspecified | 1 | 2% |
| Computer Science | 1 | 2% |
| Other | 6 | 13% |
| Unknown | 18 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 July 2018.
All research outputs
#14,370,803
of 23,012,811 outputs
Outputs from Surgical Endoscopy
#3,283
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Outputs of similar age
#239,217
of 440,933 outputs
Outputs of similar age from Surgical Endoscopy
#92
of 129 outputs
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