Inframesocolic Approach for Robotic Enucleation of Branch-Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas

J Gastrointest Surg. 2023 May;27(5):1042-1044. doi: 10.1007/s11605-023-05620-0. Epub 2023 Feb 27.

Abstract

Background: The inframesocolic approach to the uncinate process of the pancreas has been rarely described in literature. To the best of our knowledge, no robotic cases have been reported.

Methods: The case of a 74-year-old woman, with a 43-mm branch-duct intraductal papillary mucinous neoplasm with worrisome features within the uncinate process of the pancreas, is described.

Results: After diagnostic work-up, due to the uncertain potential of malignancy and the strong motivation of the patient to undergo surgery, we performed a robotic enucleation through an inframesocolic approach. The neoplasm was more than 1 cm from the main pancreatic duct. Final pathological diagnosis revealed a low-grade dysplasia branch-duct intraductal papillary mucinous neoplasm.

Conclusions: The inframesocolic approach could represent an easy way to access the uncinate process of the pancreas, allowing safe limited resection in selected cases such as small branch-duct IPMN or pancreatic neuroendocrine tumors.

Keywords: Pancreas; Pancreatic intraductal neoplasms; Robotic surgical procedures.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous* / pathology
  • Adenocarcinoma, Mucinous* / surgery
  • Aged
  • Carcinoma, Pancreatic Ductal* / pathology
  • Carcinoma, Pancreatic Ductal* / surgery
  • Carcinoma, Papillary* / pathology
  • Carcinoma, Papillary* / surgery
  • Female
  • Humans
  • Pancreatic Ducts / pathology
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery