Robotic Whipple Procedure for Pancreatic Cancer: The Moffitt Cancer Center Pathway.
BACKGROUND
Resection of malignancies in the head and uncinate process of the pancreas (Whipple procedure) using a robotic approach is emerging as a surgical option. Although several case series of the robotic Whipple procedure have been reported, detailed descriptions of operative techniques and a clear pathway for adopting this technology are lacking.


METHODS
We present a focused review of the procedure as it applies to pancreatic cancer and describe our clinical pathway for the robotic Whipple procedure used in pancreatic cancer and review the outcomes of our early experience. A systematic review of the literature is provided, focusing on the indications, variations in surgical techniques, complications, and oncological results of the robotic Whipple procedure.


RESULTS
A clinical pathway has been defined for preoperative training of surgeons, the requirements for hospital privileges, patient selection, and surgical techniques for the robotic Whipple procedure. The robotic technique for managing malignant lesions of the pancreas head is safe when following well-established guidelines for adopting the technology. Preliminary data demonstrate that perioperative convalescence may exceed end points when compared with the open technique.


CONCLUSIONS
The robotic Whipple procedure is a minimally invasive approach for select patients as part of multidisciplinary management of periampullary lesions in tertiary centers where clinicians have developed robotic surgical programs. Prospective trials are needed to define the short- and long-term benefits of the robotic Whipple procedure.
Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Mokenge.Malafa@Moffitt.org.
Omar M
OM
Rashid
John E
JE
Mullinax
Jose M
JM
Pimiento
Kenneth L
KL
Meredith
Mokenge P
MP
Malafa
D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*