Robotic Radical Antegrade Modular Pancreatosplenectomy Using the Supracolic Anterior Superior Mesenteric Artery Approach

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Takahito Yagi, Toshiyoshi Fujiwara

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Radical antegrade modular pancreatosplenectomy (RAMPS) is the standardized approach in open pancreatic resection for pancreatic body and tail cancer. However, few studies have described regarding robotic RAMPS for pancreatic cancer. We herein present our techniques of robotic RAMPS using the supracolic anterior superior mesenteric artery (SMA) approach with the ventral view. Methods: The patient was a 75-year-old female with a diagnosis of pancreatic body cancer. Following neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel, robotic RAMPS was performed. Our techniques of robotic RAMPS include four steps: (1) gastrocolic ligament division, (2) dissection of superior and inferior border of the pancreas, (3) division of the pancreas, and (4) retroperitoneal dissection. Results: The operative time was 251 min with an estimated blood loss of 10 mL. The uneventful postoperative course was observed. The final pathology confirmed R0 surgical resection. Conclusions: Robotic RAMPS using the supracolic anterior SMA approach is safe and feasible for pancreatic body and tail cancer. Standardization and precise anatomical knowledge are key elements of performing robotic RAMPS.

Original languageEnglish
JournalJournal of Gastrointestinal Surgery
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Distal pancreatectomy
  • Pancreatic cancer
  • Radical antegrade modular pancreatosplenectomy
  • Robot

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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