Hand-Assisted Laparoscopic Total Pancreatectomy: A Report of Two Cases

Dokmak, Safi; Aussilhou, B.; Sauvanet, Alain; Ruszniewski, Philippe; Lévy, Philippe; Belghiti, Jacques

doi:10.1089/lap.2012.0459

Cited by 10 publications

(1 citation statement)

References 24 publications

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“…To address this problem, several centers [ 30 – 33 ] introduced the robotic-assisted system, which could provide surgeons with precisely dissection of vessels and dexterous reconstruction. Besides, other centers [ 34 , 35 ] used the hand assisted laparoscopic technique or mini-laparotomy to address the limitations of laparoscopy. In our study, robotic system was only applied in one patient for the reconstruction procedure and it is not superior to the laparoscopic technique in terms of anastomosis because the absence of pancreatic anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic total pancreatectomy

Wang

Cai

et al. 2017

Medicine

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Rationale:Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy.Patients and Methods:Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition.Diagnosis and Outcomes:The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life.Lessons:Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic total pancreatectomy

Wang

Cai

et al. 2017

Medicine

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Laparoskopisch-assistierte totale Pankreatektomie

Kuesters

Karcz

Hopt

et al. 2014

Chirurg

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Robotic total pancreatectomy with or without autologous islet cell transplantation: replication of an open technique through a minimal access approach

et al. 2014

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Background Total Pancreatectomy (TP) is a morbid but sometimes necessary operation. Robotic TP is not often reported but may harbor some advantages compared to the open approach. This manuscript details a single institutions outcomes and technique of robotic TP. An accompanying video demonstrates a robotic TP with auto islet cell transplantation (IAT) in which: 1) the arterial blood supply and venous drainage are kept intact until the last step of the total pancreatectomy to minimize warm ischemia time and 2) extirpation of the entire pancreas is performed without dividing the pancreatic neck to maximize islet recovery. Methods A retrospective review of a prospective database of perioperative outcomes of all consecutive robotic TPs at a single institution. This included a single robotic TP with IAT performed on a twenty-year-old patient with chronic pancreatitis. Results Between 2010 and January 2014, ten robotic TPs were performed (7 males, mean age 58 years), one of which included an IAT. Median body mass index was 28. Indications were intraductal papillary mucinous neoplasms (6), pancreatic adenocarcinoma (1), and chronic pancreatitis (3). The median operative time was 560 minutes with a median estimated blood loss of 650 ml. One case was converted to laparotomy. Ninety day mortality and Clavien III-IV complication rate was 0 and 20% respectively. The average length of stay was 10 ± 3 days, with only 1 readmission within 90 days. The single TP and IAT was completed successfully without conversion, and was achieved without division of the pancreatic neck thereby maintaining vascular inflow to an entire specimen up until extraction. Conclusion This represents the largest series of robotic TP, demonstrating its safety and feasibility. Additionally, TP and IAT using the technique described above can be recapitulated using the robotic approach.

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Hand-Assisted Laparoscopic Total Pancreatectomy: A Report of Two Cases

Cited by 10 publications

References 24 publications

Laparoscopic total pancreatectomy

Laparoscopic total pancreatectomy

Laparoskopisch-assistierte totale Pankreatektomie

Robotic total pancreatectomy with or without autologous islet cell transplantation: replication of an open technique through a minimal access approach

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