Single Incision Laparoscopic Pancreas Resection for Pancreatic Metastasis of Renal Cell Carcinoma

Barbaros, Umut; Sümer, Aziz; Demirel, Tugrul; Karakullukçu, Nazlı; Batman, Burcin; Içscan, Yalın; Sarıçam, Gülay; Serin, Kürşat Rahmi; Loh, Wann Jia; Dinççağ, Ahmet; Mercan, Selçuk

doi:10.4293/108680810x12924466008448

Cited by 53 publications

(53 citation statements)

References 11 publications

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“…Ability to perform lymphadenectomy is one advantage in performing a standard resection; at this point, there is insufficient evidence to advocate whether or not a lymphadenectomy is required in this settingall that is certain is that the overwhelming majority of surgeons have favoured "typical" resections up to this point. Meanwhile, surgical technique continues to evolve in new and exciting directions, with reports emerging of single-incision laparoscopic pancreatectomy for RCC metastases [40].…”

Section: Discussionmentioning

confidence: 99%

Pancreatectomy for metastatic disease: A systematic review

Adler

Redmond

Heneghan

et al. 2014

European Journal of Surgical Oncology (EJSO)

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Aim: Tumours rarely metastasise to the pancreas. While surgical resection of such metastases is believed to confer a survival benefit, there is limited data to support such management. We present a systematic review of case series of pancreatic metastasectomy and analysis of survival outcomes.Methods: A literature search was performed using the PubMed and Cochrane databases and the reference lists of relevant articles, searching for sizeable case series of pancreatic metastasectomy with curative intent. Data extracted included basic demographics, histological primary tumour, presentation, operative management, complications and survival, while the MINORS index was used to assess study quality.Results: 18 studies were found which met our inclusion criteria, involving 399 patients. Renal cell carcinoma (RCC) was the commonest malignancy metastasising to the pancreas, responsible for 62.6% of cases, followed by sarcoma (7.2%) and colorectal carcinoma (6.2%). While survival data was not uniformly reported, the median survival post-metastasectomy was 50.2 months, with a oneyear survival of 86.81% and five-year survival of 50.02%. Median survival for RCC was 71.7 months with 70.4% five-year survival. Median survival was similar in patients with synchronous and metachronous pancreatic metastases, but patients with additional extrapancreatic metastases had a significantly shorter survival than patients with isolated pancreatic metastases (26 versus 45 months). Study quality was poor, with a median MINORS score of 10/16. Conclusions:Within the limitations of a review of non-randomised case series, it would appear that pancreatic metastasectomy confers a survival benefit in selected patients. Better evidence is required, but may prove difficult to acquire. Key words:pancreatic metastasis, metastasectomy, pancreatectomy, metastatic renal cell cancer, 3 Introduction:

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Section: Discussionmentioning

confidence: 99%

Pancreatectomy for metastatic disease: A systematic review

Adler

Redmond

Heneghan

et al. 2014

European Journal of Surgical Oncology (EJSO)

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“…in the english literature, to the best of our knowledge, there are only four papers with only five cases of single-port pancreas resection (1,3,7,13) . The main reason is that the majority of systems available for single site laparoscopic surgery need special articulating instruments, use of small laparoscopes with poor triangulation.…”

Section: Discussionmentioning

confidence: 99%

“…First, retraction is significantly limited. To overcome this problem some surgeons use stay sutures with straight needles to improve retraction (1,3,13) . Another issue is the triangulation.…”

Section: Discussionmentioning

confidence: 99%

First Single-Port Laparoscopic Pancreatectomy in Brazil

Machado¹,

Surjan²,

Makdissi³

2013

Arq. Gastroenterol.

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-Context -Pancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. in the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. in the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures. Objectives -We present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and latin America. Methods -A 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used. Results -operative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions -Single-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons. HEADINGS -Pancreatectomy. laparoscopy.

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“…It seems that reduced-port or single-port laparoscopic surgery is frequently performed for standard laparoscopic procedures including appendectomies, cholecystectomies, and colectomies. [5][6][7] Barbaros et al 8 reported the first single-incision laparoscopic DP performed in a 59-year-old female to treat pancreatic metastasis from renal cell carcinoma. Since then, the number of cases treated with laparoscopic single port (LSP) or laparoscopic reduced port (LRP) DP procedures has increased (Fig.…”

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confidence: 99%

Minimally Invasive (Laparoscopic or Robotic) Reduced Port (Single Port) Distal Pancreatectomy

Kang

2017

J Minim Invasive Surg

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In spite of lack of randomized control study, laparoscopic distal pancreatectomy (DP) is regarded as appropriate treatment in managing benign and low grade malignant tumor in distal part of the pancreas. With the advance of laparoscopic skills, innovative instruments, and perioperative management, clinical effort to reduce the access injury for laparoscopic DP has been attempted to enhance the cosmetic effect and the benefit of minimally invasive surgery. Due to inborn technical limitation of laparoscopic surgical system, it is not easy to perform laparoscopic reduced port-or single port-distal pancreatectomy (LRP/LSP-DP) in daily routine clinical practice, however, surgical technique for safe and effective LRP/LSP-DP has been developed. Till now, only a few experts reported the technical feasibility and safety of LRP/LSP-DP in selected patients. According to literature review, the number of the patients who underwent LRP/LSP-DP seems to gradually increase. In this moment, surgical experiences may be too limited to reach the conclusion, but, with the help of robotic surgical system, LRP/LSP-DP has potential room for further investigation. Therefore, minimally invasive surgeons need to pay attention to this innovative movement. In this review, currently available surgical techniques for LRP/LSP-DP has been summarized with some future perspectives on this technique.

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Single Incision Laparoscopic Pancreas Resection for Pancreatic Metastasis of Renal Cell Carcinoma

Abstract: Results of this study suggest that single incision laparoscopic subtotal pancreatectomy may be safely performed in centers experienced with advanced laparoscopic procedures.

Cited by 53 publications

References 11 publications

Pancreatectomy for metastatic disease: A systematic review

Pancreatectomy for metastatic disease: A systematic review

First Single-Port Laparoscopic Pancreatectomy in Brazil

Minimally Invasive (Laparoscopic or Robotic) Reduced Port (Single Port) Distal Pancreatectomy

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