THE USE OF DA VINCI XI FOR ROBOTIC LEFT-SUBTOTAL SPLENOPANCREATECTOMY IN A PANCREATIC NECK CARCINOMA

Background: The da Vinci Xi system have a hybrid structure that allows multiquadrant surgery and reduce instruments collision. We present a case of a solid mass of pancreatic body determining compression of splenomesenteric confluence that was treated with robotic left subtotal splenopancreatectomy. Methods: A 78-years old man with an incidental finding of at US and then confirmed with CT scan a lesion of the neck of the pancreas located just above the spleno-mesenteric confluence, was operated with the da Vinci Xi platform. For the procedure, the patient was positioned in a supine position and trocars were disposed in a rectilinear line just above the peri-umbelical area Results: The operative time was 350 min. The pancreatic parenchymal section was performed at the level of gastroduodenal artery and the operation was completed totally robotic, despite the compression of the lesion with the spleno-portal-mesenteric confluence. No complications or intra operative conversion were noted. The patient was discharged on the 7th postoperative day without any complications. Conclusions: The new da Vinci Xi gives the possibility to move faster and without collision from different surgical fields such as epigastric area for pancreatic neck transection till the left upper quadrant for splenectomy. The longer instrument and the magnified vision make these challenging procedures easier to be performed robotically. These advantages could improve the widespread of minimally invasive surgery for the treatment of pancreatic diseases