Initial experience with laparoscopic and robotic surgery for the treatment of periampullary tumours: single

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Brian K P Goh1,2, Tze-Yi Low1, Juinn-Huar Kam1

  • 1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.

ANZ Journal of Surgery
|February 27, 2019
PubMed
Abstract

Insights

Minimally invasive surgery (MIS) for pancreatoduodenectomy (PD) is safe for periampullary tumors. Robotic surgery (RS) showed a shorter learning curve than laparoscopic surgery (LS), enabling quicker adoption of fully MIS procedures.

Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Minimally invasive surgery (MIS) for pancreatoduodenectomy (PD) raises safety concerns during the initial learning phase.
  • This study evaluates the early experience with MIS for periampullary tumors.

Purpose of the Study:

  • To assess the safety and feasibility of laparoscopic surgery (LS) and robotic surgery (RS) for pancreatoduodenectomy (PD) in periampullary tumors.
  • To compare the learning curves and outcomes between LS and RS in this patient cohort.

Main Methods:

  • Retrospective review of 30 consecutive patients undergoing LS or RS for periampullary tumors (2014-2017).
  • Procedures included pancreatoduodenectomy (PD), total pancreatectomies (TPs), and palliative bypasses.
  • Data collected on operative details, conversions, morbidities, and mortality.

Main Results:

  • Fourteen percent of patients required open conversion, exclusively in the LS group.
  • Major morbidities occurred in 16.7% of patients, including pancreatic fistulas.
  • Robotic surgery (RS) demonstrated a higher likelihood of totally MIS completion (50% vs. 0%) and tended towards shorter post-operative stays (8 vs. 14.5 days).

Conclusions:

  • Both laparoscopic surgery (LS) and robotic surgery (RS) can be safely implemented for periampullary tumor treatment.
  • Robotic surgery (RS) appears to have a shorter learning curve, facilitating a faster transition to totally MIS procedures compared to LS.
Keywords:
laparoscopic pancreatectomylaparoscopic pancreatoduodenectomyrobotic pancreatectomyrobotic pancreatoduodenectomywhipples procedure

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