Related Experiment Video
Updated: Aug 5, 2026
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Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique
Published on: August 14, 2021
Robotic RAMPS with 360° celiac axis skeletonization: a standardized vascular approach (technical note with video)
Francesca Marcucci1, Alessia Fassari2, Alexandru Amariutei3
1Hepato‑Biliary and Pancreatic Surgery Unit, Department of Surgery, Pôle Santé Sud, 28 Rue de Guetteloup, 72100, Le Mans, France. marcuccifrancesca.md@gmail.com.
Updates in Surgery
|July 28, 2026
Summary
Robotic anterior radical antegrade modular pancreatosplenectomy (RAMPS) improves safety and reproducibility. This technique standardizes vascular dissection for left-sided pancreatic cancer, enhancing oncological clearance.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Robotic Surgery
Background:
- Radical antegrade modular pancreatosplenectomy (RAMPS) is a key procedure for left-sided pancreatic cancer.
- Robotic approaches are increasingly used for RAMPS.
- Vascular dissection of the celiac axis and superior mesenteric artery (SMA) is technically challenging and lacks standardized strategies.
Purpose of the Study:
- To describe a standardized robotic anterior RAMPS technique.
- To detail an approach using early SMA exposure via the ligament of Treitz.
- To emphasize systematic celiac axis dissection and 360° arterial skeletonization.
Main Methods:
- A robotic anterior RAMPS approach was employed.
- Early SMA exposure was achieved through the ligament of Treitz.
- Systematic, layer-by-layer dissection of the celiac axis and SMA was performed.
Main Results:
- The procedure was successfully illustrated in a patient with pancreatic body adenocarcinoma.
- Operative time was 240 minutes with minimal blood loss.
- Histopathology confirmed R0 resection and no lymph node metastasis (0/15).
Conclusions:
- This standardized vascular approach enhances reproducibility and safety in robotic RAMPS.
- The technique facilitates precise arterial dissection.
- Adequate oncological clearance is achievable with this method.
