Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 245] Left-sided SMA Approach for Regional Lymph Node Dissection in Robot-assisted Pancreaticoduodenectomy for Pancreatic Cancer
Ryuichi YOSHIDA 1, Hiroyoshi MATSUKAWA 1, Daisuke SATO 1, Hiroaki MASHIMA 1, Masashi YOSHIMOTO 1, Michihiro ISHIDA 1, Shigehiro SHIOZAKI 1
1 Surgery, Hiroshima Citizens Hospital, JAPAN
Background : We introduced robot-assisted pancreaticoduodenectomy (RPD) in May 2023 and have performed RPD for 10 cases. In this report, we present our surgical procedure using SMA left approach in RPD for pancreatic cancer, and the short-term results of RPD.
Methods : In RPD for pancreatic cancer, we performed SMA left approach. The resection process was divided into (1) SMA left approach, (2) SMV exposure and gastrectomy, (3) hepatoduodenal ligament dissection / pancreatic dissection, and (4) SMA right approach. In the left SMA approach, camera was inserted from the left side of the patient, approaching the outermost layer of the SMA plexus to dissect the number 14 lymph node.
Results : Of the 10 patients performed RPD, the primary diseases were IPMN/PDAC/PNET/bile duct cancer/ ampulla of Vater cancer: 4/3/1/1/1. The overall median operation time was 682 min. The median amount of intraoperative blood loss was 105 cc. Postoperative complications included no open conversion, 1 case of C-D IIIA, 2 cases of clinical pancreatic fistula, no bile leakage. The median length of postoperative hospital stay was 20 days. Comparing the SMA left approach group (N=4) and without SMA left approach group(N=6), the operative time was 727 vs. 656 min., amount of intraoperative blood loss was 115 vs. 95cc. No statistically significant difference was found between the groups, including other complication rates.
Conclusions : In the RPD induction phase, regional lymph node dissection for pancreatic cancer using the SMA left-sided approach was performed safely.
Methods : In RPD for pancreatic cancer, we performed SMA left approach. The resection process was divided into (1) SMA left approach, (2) SMV exposure and gastrectomy, (3) hepatoduodenal ligament dissection / pancreatic dissection, and (4) SMA right approach. In the left SMA approach, camera was inserted from the left side of the patient, approaching the outermost layer of the SMA plexus to dissect the number 14 lymph node.
Results : Of the 10 patients performed RPD, the primary diseases were IPMN/PDAC/PNET/bile duct cancer/ ampulla of Vater cancer: 4/3/1/1/1. The overall median operation time was 682 min. The median amount of intraoperative blood loss was 105 cc. Postoperative complications included no open conversion, 1 case of C-D IIIA, 2 cases of clinical pancreatic fistula, no bile leakage. The median length of postoperative hospital stay was 20 days. Comparing the SMA left approach group (N=4) and without SMA left approach group(N=6), the operative time was 727 vs. 656 min., amount of intraoperative blood loss was 115 vs. 95cc. No statistically significant difference was found between the groups, including other complication rates.
Conclusions : In the RPD induction phase, regional lymph node dissection for pancreatic cancer using the SMA left-sided approach was performed safely.
SESSION
E-poster
E-Session 03/21 ALL DAY