title: Robotic central pancreatectomy with stented pancreaticogastrostomy: operative details.
abstract: BACKGROUND
  Central pancreatectomy (CP) is increasingly being used to treat selected lesions of the central pancreatic segment. A step-by-step technique for robotic CP is described and a literature review provided for this minimally invasive approach.
  
  
  METHODS
  A 55-year-old woman was referred to the authors' center for the treatment of a single 4 cm lesion located at the proximal part of the pancreatic body. The da Vinci Robotic surgical system® with a five trocar technique was used. The pancreatic neck was transected using an endoscopic stapler. The pancreatic body was progressively dissected from the splenic vessels right to left and sectioned with an appropriate oncologic margin. A pancreaticogastrostomy protected by a transanastomotic external stent was constructed to the distal pancreatic stump.
  
  
  RESULTS
  Surgery lasted 450 min (8 min docking time) with minimal blood loss. Pathology showed a 28 mm well-differentiated neuroendocrine pancreatic tumor with tumor-free resection margins. The patient was discharged home on postoperative day 15 in good condition.
  
  
  CONCLUSIONS
  Robotic surgery can be safely used for complex pancreatic resection requiring pancreaticoenteric reconstruction. The experience reported so far is still limited but the results are encouraging; robotics shows the potential to bridge the gap between minimally invasive surgery and advanced pancreatic surgery.
authors.affiliation: Hopital de Hautpierre, Hopitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.forename: Ettore
authors.initials: E
authors.lastname: Marzano
authors.forename: Cinzia
authors.initials: C
authors.lastname: Nobili
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
mesh_terms: D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000379:methods*; D013154:Spleen / Q000601:surgery; D015607:Stents; D013270:Stomach / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome