ROBOTIC LEFT-SUBTOTAL SPLENOPANCREATECTOMY FOR A PANCREATIC NECK CARCINOMA

Aims: The da Vinci Xi represents an evolution of the previous da Vinci Si and traditional laparoscopy, allowing an easier and faster surgery in challenging procedures, such as pancreatic resections. We are presenting a case of a left subtotal splenopancreatectomy for a solid lesion of the body of the pancreas, determining compression on the splenomesenteric confluence, performed by using the da Vinci Xi. Methods: A 78-years old man with an incidental finding at US of a lesion of the neck of the pancreas located just above the spleno-mesenteric confluence, confirmed with a CT scan, was operated with the da Vinci Xi platform. For the procedure, we used the upper quadrants trocars disposition suggested by Intuitive. Results: The operation was successfully completed in 350 min. The left subtotal splenopancreatectomy, with section of the pancreas at the gastroduodenal artery level, was performed totally robotic, despite the contact of the lesion with the spleno-portal-mesenteric confluence, determining compression, without signs of infiltration. No conversion or intra-operative complications were recorded. The postoperative course was uneventful and the patient was discharged on the 7th postoperative day. Conclusions: The da Vinci Xi gives some advantages in pancreatic surgery allowing to perform challenging procedures, such as pancreatic resections for lesions close to the vessels, with a minimally invasive technique. These advantages could improve the widespread of minimally invasive surgery for the treatment of pancreatic disease.