Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application
Background Advanced and delicate laparoscopic techniques are usually required for safe and successful laparoscopic spleen-preserving distal pancreatectomy. The unique characteristics of robotic surgical system are thought to be useful for this minimally invasive procedure. Methods From September 200...
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| Veröffentlicht in: | Surgical endoscopy 2013-03, Vol.27 (3), p.774-781 |
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| creator | Hwang, Ho Kyoung Kang, Chang Moo Chung, Young Eun Kim, Kyung Ah Choi, Sung Hoon Lee, Woo Jung |
| description | Background
Advanced and delicate laparoscopic techniques are usually required for safe and successful laparoscopic spleen-preserving distal pancreatectomy. The unique characteristics of robotic surgical system are thought to be useful for this minimally invasive procedure.
Methods
From September 2007 to May 2011, patients who underwent robot-assisted, spleen-preserving, distal pancreatectomy for benign and borderline malignant tumors of the pancreas were retrospectively reviewed. Perioperative clinicopathologic surgical outcomes were evaluated.
Results
Twenty-two patients were attempted for robot-assisted, spleen-preserving, distal pancreatectomy, and in 21 patients (95.5 %), the spleen was saved either by splenic vessels conservation (SVC;
n
= 17, 81 %) or by splenic vessels sacrifice (SVS;
n
= 4, 19 %). Seven patients were male and 15 were female with a mean age of 43.2 ± 15.2 years. Pathologic diagnosis included MCT in five patients, SCT in five, SPT in four, IPMT in three, NET in three, and other benign conditions in two. The mean operation time was 398.9 ± 166.3 min, but it gradually decreased as experiences were accumulated (Rsq = 0.223,
p
= 0.023). Intraoperative blood loss was 361.3 ± 360.1 ml, and intraoperative transfusion was required in four patients (18.1 %). A soft diet was given for 1.2 ± 0.4 days, and the length of hospital stay was 7.0 ± 2.4 days postoperatively. Clinically relevant pancreatic fistula was noted in two patients (9.1 %) but was successfully managed conservatively. Most patients (87.5 %) showed patency in conserved both splenic vessels, and only two patients (12.5 %) had partially or completely obliterated in splenic veins in the SVC-SpDP group. Partially impaired splenic perfusion was observed in one patient in the SVS-SpDP group. The perfusion defect area decreased without any clinical symptom after 4 months.
Conclusions
The robotic surgical system is thought to be beneficial for improving the spleen-preservation rate in laparoscopic distal pancreatectomy. Robot-assisted approach can be chosen for patients who require spleen-preserving distal pancreatectomy. |
| doi_str_mv | 10.1007/s00464-012-2551-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1288314627</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1288314627</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-2a3a243cfb4cfe72f8ba1fc1db80567b330d8ae97863751a961a8ababbbe5f43</originalsourceid><addsrcrecordid>eNp1kc2KFTEQhYMoznX0AdxIwI2baP66k3Yng38wIMjsQ5KuvvTQN4mpbnEWA76Gr-eTmMsdRQRXqXC-c6rgEPJU8JeCc_MKOde9ZlxIJrtOsP4e2Qmt2k8Ke5_s-KA4k2bQZ-QR4jVv-CC6h-RMKt7JTpoduf2cQ16ZR5xxhZFiWQASKxUQ6tc57enYBL_Q4lOs4FeIaz7cvKaeYlMXoLjVPeT08_sPpPCtQJ0hRUDq00hLzSVjc-eJxmVOc2yzL2Vpwzrn9Jg8mPyC8OTuPSdX795eXXxgl5_ef7x4c8miVnZl0isvtYpT0HECIycbvJiiGIPlXW-CUny0HgZje2U64YdeeOuDDyFAN2l1Tl6cYts9XzbA1R1mjLAsPkHe0AlprRK6l6ahz_9Br_NWUzvuSBllBmtso8SJijUjVphcqfPB1xsnuDtW407VuFaNO1bj-uZ5dpe8hQOMfxy_u2iAPAHYpLSH-tfq_6b-AqVgnTk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1287379878</pqid></control><display><type>article</type><title>Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Hwang, Ho Kyoung ; Kang, Chang Moo ; Chung, Young Eun ; Kim, Kyung Ah ; Choi, Sung Hoon ; Lee, Woo Jung</creator><creatorcontrib>Hwang, Ho Kyoung ; Kang, Chang Moo ; Chung, Young Eun ; Kim, Kyung Ah ; Choi, Sung Hoon ; Lee, Woo Jung</creatorcontrib><description>Background
Advanced and delicate laparoscopic techniques are usually required for safe and successful laparoscopic spleen-preserving distal pancreatectomy. The unique characteristics of robotic surgical system are thought to be useful for this minimally invasive procedure.
Methods
From September 2007 to May 2011, patients who underwent robot-assisted, spleen-preserving, distal pancreatectomy for benign and borderline malignant tumors of the pancreas were retrospectively reviewed. Perioperative clinicopathologic surgical outcomes were evaluated.
Results
Twenty-two patients were attempted for robot-assisted, spleen-preserving, distal pancreatectomy, and in 21 patients (95.5 %), the spleen was saved either by splenic vessels conservation (SVC;
n
= 17, 81 %) or by splenic vessels sacrifice (SVS;
n
= 4, 19 %). Seven patients were male and 15 were female with a mean age of 43.2 ± 15.2 years. Pathologic diagnosis included MCT in five patients, SCT in five, SPT in four, IPMT in three, NET in three, and other benign conditions in two. The mean operation time was 398.9 ± 166.3 min, but it gradually decreased as experiences were accumulated (Rsq = 0.223,
p
= 0.023). Intraoperative blood loss was 361.3 ± 360.1 ml, and intraoperative transfusion was required in four patients (18.1 %). A soft diet was given for 1.2 ± 0.4 days, and the length of hospital stay was 7.0 ± 2.4 days postoperatively. Clinically relevant pancreatic fistula was noted in two patients (9.1 %) but was successfully managed conservatively. Most patients (87.5 %) showed patency in conserved both splenic vessels, and only two patients (12.5 %) had partially or completely obliterated in splenic veins in the SVC-SpDP group. Partially impaired splenic perfusion was observed in one patient in the SVS-SpDP group. The perfusion defect area decreased without any clinical symptom after 4 months.
Conclusions
The robotic surgical system is thought to be beneficial for improving the spleen-preservation rate in laparoscopic distal pancreatectomy. Robot-assisted approach can be chosen for patients who require spleen-preserving distal pancreatectomy.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-012-2551-6</identifier><identifier>PMID: 23052527</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adult ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Laparoscopy - methods ; Length of Stay ; Male ; Medicine ; Medicine & Public Health ; Operative Time ; Organ Sparing Treatments - methods ; Pancreas ; Pancreatectomy - methods ; Pancreatic Neoplasms - surgery ; Proctology ; Retrospective Studies ; Robotics ; Robotics - methods ; Robots ; Spleen ; Spleen - blood supply ; Spleen - surgery ; Surgeons ; Surgery ; Surgical outcomes ; Surgical techniques ; Treatment Outcome ; Tumors ; Vascular Patency - physiology</subject><ispartof>Surgical endoscopy, 2013-03, Vol.27 (3), p.774-781</ispartof><rights>Springer Science+Business Media, LLC 2012</rights><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-2a3a243cfb4cfe72f8ba1fc1db80567b330d8ae97863751a961a8ababbbe5f43</citedby><cites>FETCH-LOGICAL-c438t-2a3a243cfb4cfe72f8ba1fc1db80567b330d8ae97863751a961a8ababbbe5f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-012-2551-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-012-2551-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23052527$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hwang, Ho Kyoung</creatorcontrib><creatorcontrib>Kang, Chang Moo</creatorcontrib><creatorcontrib>Chung, Young Eun</creatorcontrib><creatorcontrib>Kim, Kyung Ah</creatorcontrib><creatorcontrib>Choi, Sung Hoon</creatorcontrib><creatorcontrib>Lee, Woo Jung</creatorcontrib><title>Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Advanced and delicate laparoscopic techniques are usually required for safe and successful laparoscopic spleen-preserving distal pancreatectomy. The unique characteristics of robotic surgical system are thought to be useful for this minimally invasive procedure.
Methods
From September 2007 to May 2011, patients who underwent robot-assisted, spleen-preserving, distal pancreatectomy for benign and borderline malignant tumors of the pancreas were retrospectively reviewed. Perioperative clinicopathologic surgical outcomes were evaluated.
Results
Twenty-two patients were attempted for robot-assisted, spleen-preserving, distal pancreatectomy, and in 21 patients (95.5 %), the spleen was saved either by splenic vessels conservation (SVC;
n
= 17, 81 %) or by splenic vessels sacrifice (SVS;
n
= 4, 19 %). Seven patients were male and 15 were female with a mean age of 43.2 ± 15.2 years. Pathologic diagnosis included MCT in five patients, SCT in five, SPT in four, IPMT in three, NET in three, and other benign conditions in two. The mean operation time was 398.9 ± 166.3 min, but it gradually decreased as experiences were accumulated (Rsq = 0.223,
p
= 0.023). Intraoperative blood loss was 361.3 ± 360.1 ml, and intraoperative transfusion was required in four patients (18.1 %). A soft diet was given for 1.2 ± 0.4 days, and the length of hospital stay was 7.0 ± 2.4 days postoperatively. Clinically relevant pancreatic fistula was noted in two patients (9.1 %) but was successfully managed conservatively. Most patients (87.5 %) showed patency in conserved both splenic vessels, and only two patients (12.5 %) had partially or completely obliterated in splenic veins in the SVC-SpDP group. Partially impaired splenic perfusion was observed in one patient in the SVS-SpDP group. The perfusion defect area decreased without any clinical symptom after 4 months.
Conclusions
The robotic surgical system is thought to be beneficial for improving the spleen-preservation rate in laparoscopic distal pancreatectomy. Robot-assisted approach can be chosen for patients who require spleen-preserving distal pancreatectomy.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Operative Time</subject><subject>Organ Sparing Treatments - methods</subject><subject>Pancreas</subject><subject>Pancreatectomy - methods</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Robotics</subject><subject>Robotics - methods</subject><subject>Robots</subject><subject>Spleen</subject><subject>Spleen - blood supply</subject><subject>Spleen - surgery</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Vascular Patency - physiology</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc2KFTEQhYMoznX0AdxIwI2baP66k3Yng38wIMjsQ5KuvvTQN4mpbnEWA76Gr-eTmMsdRQRXqXC-c6rgEPJU8JeCc_MKOde9ZlxIJrtOsP4e2Qmt2k8Ke5_s-KA4k2bQZ-QR4jVv-CC6h-RMKt7JTpoduf2cQ16ZR5xxhZFiWQASKxUQ6tc57enYBL_Q4lOs4FeIaz7cvKaeYlMXoLjVPeT08_sPpPCtQJ0hRUDq00hLzSVjc-eJxmVOc2yzL2Vpwzrn9Jg8mPyC8OTuPSdX795eXXxgl5_ef7x4c8miVnZl0isvtYpT0HECIycbvJiiGIPlXW-CUny0HgZje2U64YdeeOuDDyFAN2l1Tl6cYts9XzbA1R1mjLAsPkHe0AlprRK6l6ahz_9Br_NWUzvuSBllBmtso8SJijUjVphcqfPB1xsnuDtW407VuFaNO1bj-uZ5dpe8hQOMfxy_u2iAPAHYpLSH-tfq_6b-AqVgnTk</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Hwang, Ho Kyoung</creator><creator>Kang, Chang Moo</creator><creator>Chung, Young Eun</creator><creator>Kim, Kyung Ah</creator><creator>Choi, Sung Hoon</creator><creator>Lee, Woo Jung</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application</title><author>Hwang, Ho Kyoung ; Kang, Chang Moo ; Chung, Young Eun ; Kim, Kyung Ah ; Choi, Sung Hoon ; Lee, Woo Jung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-2a3a243cfb4cfe72f8ba1fc1db80567b330d8ae97863751a961a8ababbbe5f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Operative Time</topic><topic>Organ Sparing Treatments - methods</topic><topic>Pancreas</topic><topic>Pancreatectomy - methods</topic><topic>Pancreatic Neoplasms - surgery</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Robotics</topic><topic>Robotics - methods</topic><topic>Robots</topic><topic>Spleen</topic><topic>Spleen - blood supply</topic><topic>Spleen - surgery</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Vascular Patency - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hwang, Ho Kyoung</creatorcontrib><creatorcontrib>Kang, Chang Moo</creatorcontrib><creatorcontrib>Chung, Young Eun</creatorcontrib><creatorcontrib>Kim, Kyung Ah</creatorcontrib><creatorcontrib>Choi, Sung Hoon</creatorcontrib><creatorcontrib>Lee, Woo Jung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hwang, Ho Kyoung</au><au>Kang, Chang Moo</au><au>Chung, Young Eun</au><au>Kim, Kyung Ah</au><au>Choi, Sung Hoon</au><au>Lee, Woo Jung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>27</volume><issue>3</issue><spage>774</spage><epage>781</epage><pages>774-781</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Advanced and delicate laparoscopic techniques are usually required for safe and successful laparoscopic spleen-preserving distal pancreatectomy. The unique characteristics of robotic surgical system are thought to be useful for this minimally invasive procedure.
Methods
From September 2007 to May 2011, patients who underwent robot-assisted, spleen-preserving, distal pancreatectomy for benign and borderline malignant tumors of the pancreas were retrospectively reviewed. Perioperative clinicopathologic surgical outcomes were evaluated.
Results
Twenty-two patients were attempted for robot-assisted, spleen-preserving, distal pancreatectomy, and in 21 patients (95.5 %), the spleen was saved either by splenic vessels conservation (SVC;
n
= 17, 81 %) or by splenic vessels sacrifice (SVS;
n
= 4, 19 %). Seven patients were male and 15 were female with a mean age of 43.2 ± 15.2 years. Pathologic diagnosis included MCT in five patients, SCT in five, SPT in four, IPMT in three, NET in three, and other benign conditions in two. The mean operation time was 398.9 ± 166.3 min, but it gradually decreased as experiences were accumulated (Rsq = 0.223,
p
= 0.023). Intraoperative blood loss was 361.3 ± 360.1 ml, and intraoperative transfusion was required in four patients (18.1 %). A soft diet was given for 1.2 ± 0.4 days, and the length of hospital stay was 7.0 ± 2.4 days postoperatively. Clinically relevant pancreatic fistula was noted in two patients (9.1 %) but was successfully managed conservatively. Most patients (87.5 %) showed patency in conserved both splenic vessels, and only two patients (12.5 %) had partially or completely obliterated in splenic veins in the SVC-SpDP group. Partially impaired splenic perfusion was observed in one patient in the SVS-SpDP group. The perfusion defect area decreased without any clinical symptom after 4 months.
Conclusions
The robotic surgical system is thought to be beneficial for improving the spleen-preservation rate in laparoscopic distal pancreatectomy. Robot-assisted approach can be chosen for patients who require spleen-preserving distal pancreatectomy.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>23052527</pmid><doi>10.1007/s00464-012-2551-6</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2013-03, Vol.27 (3), p.774-781 |
| issn | 0930-2794 1432-2218 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Adult Female Gastroenterology Gynecology Hepatology Humans Laparoscopy Laparoscopy - methods Length of Stay Male Medicine Medicine & Public Health Operative Time Organ Sparing Treatments - methods Pancreas Pancreatectomy - methods Pancreatic Neoplasms - surgery Proctology Retrospective Studies Robotics Robotics - methods Robots Spleen Spleen - blood supply Spleen - surgery Surgeons Surgery Surgical outcomes Surgical techniques Treatment Outcome Tumors Vascular Patency - physiology |
| title | Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application |
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