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Updated: Oct 24, 2025
Robot-Assisted Radical Antegrade Modular Pancreatosplenectomy Including Resection and Reconstruction of the Spleno-Mesenteric Junction
Published on: January 3, 2020
Robotic Radical Antegrade Modular Pancreatosplenectomy Using the Supracolic Anterior Superior Mesenteric Artery
Kosei Takagi1, Yuzo Umeda2, Ryuichi Yoshida2
1Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. kotakagi15@gmail.com.
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.
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