Robotic distal pancreatectomy combined with celiac axis resection

A subset of pancreatic body and tail cancers present with locally advanced disease due to involvement of the celiac axis. Previously considered unresectable, these T4 tumors may be extirpated with a distal pancreatectomy and en bloc resection of the celiac trunk in carefully selected patients. In the setting of multimodality treatment, these resections can yield survival similar to resectable and borderline resectable lesions. Robotic surgery has been shown to be safe and feasible in complex pancreatic resections. This article summarizes our patient selection criteria and operative approach to robotic distal pancreatectomy with celiac axis resection (DP-CAR) for locally advanced body and tail tumors of the pancreas.