Robotic-assisted laparoscopic surgery can be performed for all types of pancreatic diseases, including pancreatic adenocarcinoma, neuroendocrine tumors, cystic tumors, benign masses and chronic pancreatitis. Open surgery still is recommended when the surgery involves extensive reconstruction of arteries or veins.
While minimally invasive surgery has been performed on many parts of the body, surgeons have until recently struggled to utilize this technique when operating on the pancreas because of its location and complexity.
At UCLA, surgeons now are using robotic, minimally invasive surgery to successfully operate on the pancreas. The advance means that many more patients, including those with pancreatic cancer, can undergo less traumatic operations that allow them to heal faster and proceed to other treatments, such as chemotherapy, more quickly. “We offer robotic pancreatic surgery to every patient whom we believe is an appropriate candidate,” says UCLA surgeon Mark Girgis, MD.
Traditionally, operating on the pancreas required a large incision to provide surgeons with a wide field of vision and allow them to remove tumors or parts of the organ. Minimally invasive laparoscopic surgery on the pancreas was challenging because surgeons had limited range of motion and limited vision while working on the organ through tiny incisions in the belly. Robotic surgery was a game-changer, however, enabling surgeons to have a much greater range of motion and better visualization of the pancreas.
During robotic surgery, the surgeon sits at a computer console and manipulates surgical tools, including a small 3D camera, which are attached to the robot’s arms and inserted into the patient through several small incisions. “The most common misconception is that somehow the robot is autonomous,” says UCLA surgeon Jonathan C. King, MD. “The robot is just a tool that we use to be able to do some of these complicated maneuvers. But it is completely controlled by the operating surgeon.”
Having several incisions that are under a half-inch long rather than a six-inch incision can make a big difference in how a patient recovers, Dr. Girgis says. “The surgery on the inside of the abdomen is exactly the same, whether it’s done minimally invasive with a robot or through a larger open incision,” he says. “The difference is that the amount of trauma to the patient is less. There is less pain and less blood loss, and the recovery time is reduced.” Patients typically spend less time in the hospital following minimally invasive surgery. And, for patients with pancreatic cancer, a shorter recovery can mean moving on to chemotherapy without delay. “It’s a huge benefit because a lot of those patients are debilitated and struggling in general,” Dr. Girgis says. “With a less traumatic surgery, they recover faster and get chemotherapy more reliably.”
Robotic-assisted laparoscopic surgery can be performed for all types of pancreatic diseases, including pancreatic adenocarcinoma, neuroendocrine tumors, cystic tumors, benign masses and chronic pancreatitis. Open surgery still is recommended when the surgery involves extensive reconstruction of arteries or veins, Dr. King says.
Both Drs. Girgis and King are specially trained in robotic pancreatic surgery.
“It’s wonderful that we have this option for patients,” says Timothy Donahue, MD, chief of pancreatic surgery. “This surgery is what would be considered a state-of-the-art treatment approach.”
