Robot-assisted total laparoscopic pancreaticoduodenectomy with transvaginal specimen extraction: a case report

Natural orifice specimen extraction surgery reduces incision-related complications and accelerates postoperative recovery while maintaining oncologic safety, whereas the da Vinci robotic surgical system further enhances the precision of minimally invasive procedures. This case report describes a robot-assisted total laparoscopic pancreaticoduodenectomy combined with transvaginal specimen extraction (RPD-TVSE). The patient was a 64-year-old female with moderately differentiated adenocarcinoma of the descending duodenum. The procedure took 350 min, with intraoperative blood loss of 200 mL; no blood transfusion was administered during the perioperative period. The patient was able to ambulate on postoperative day 1, with no adverse events recorded. Histopathology confirmed tumor staging as pT2N0M0, with all surgical margins negative. At 12-month follow-up, no evidence of recurrence was observed. This case demonstrates that RPD-TVSE is technically feasible and yields favorable short-term outcomes, providing a novel minimally invasive surgical option for female patients. However, long-term oncologic safety requires further investigation and validation.