200 consecutive laparoscopic pancreatic resections performed with a robotically controlled laparoscope holder

Surg Endosc. 2013 Oct;27(10):3781-91. doi: 10.1007/s00464-013-2969-5. Epub 2013 May 4.

Abstract

Introduction: Because of the potential benefit of robotics in pancreatic surgery, we review our experience at two minimally invasive pancreatic surgery centers that utilize a robotically controlled laparoscope holder to see if smaller robots that enable the operating surgeon to maintain contact with the patient may have a role in the treatment of pancreatic disease.

Methods: From March 1994 to June 2011, a total of 200 laparoscopic pancreatic procedures utilizing a robotically controlled laparoscope holder were performed.

Results: A total of 72 duodenopancreatectomies, 67 distal pancreatectomies, 23 enucleations, 20 pancreatic cyst drainage procedures, 5 necrosectomies, 5 atypical pancreatic resections, 4 total pancreatectomies, and 4 central pancreatectomies were performed. Fourteen patients required conversion to an open approach and eight a hand-assisted one. A total of 24 patients suffered a major complication. Sixteen patients developed a pancreatic leak and 19 patients required reoperation. Major complications occurred in 14 patients and pancreatic leaks occurred in 13 patients. Ten patients required conversion to a lap-assisted or open approach and six patients required reoperation.

Conclusions: Currently, a robotically assisted approach using a camera holder seems the only way to incorporate some of the benefits of robotics in pancreatic surgery while maintaining haptics and contact with the patient.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Aged
  • Drainage / instrumentation
  • Drainage / methods
  • Equipment Design
  • Female
  • Hand-Assisted Laparoscopy / methods
  • Hand-Assisted Laparoscopy / statistics & numerical data
  • Humans
  • Laparoscopes*
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Laparotomy / statistics & numerical data
  • Male
  • Middle Aged
  • Pancreatectomy / instrumentation
  • Pancreatectomy / methods*
  • Pancreatectomy / statistics & numerical data
  • Pancreatic Cyst / surgery
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy / instrumentation
  • Pancreaticoduodenectomy / methods*
  • Pancreatitis, Chronic / surgery
  • Postoperative Complications / epidemiology
  • Reoperation
  • Retrospective Studies
  • Robotics / instrumentation*