The international journal of medical robotics + computer assisted surgery : MRCAS · 2019
Robotic transduodenal ampullectomy: A novel minimally invasive approach for ampullary neoplasms.
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Lee Jin Woo, Choi Sung Hoon, Chon Hong Jae, Kim Dae Jung, Kim Gwangil, Kwon Chang Il, Ko Kwang Hyun
Аннотация
BACKGROUND: The adoption of minimally invasive surgery for transduodenal ampullectomy has been slow because of special characteristics and complexity of this procedure.
METHODS: Six patients underwent robotic transduodenal ampullectomy. We employed novel methods to facilitate exposure of the ampulla.
RESULTS: All patients completed robotic transduodenal ampullectomy, but one patient was immediately converted to robotic pancreaticoduodenectomy because of presence of invasive carcinoma on frozen biopsy. The final pathologic report revealed high-grade dysplasia in four patients, low-grade dyplasia in one, and T2N0 in one patient who converted to pancreaticoduodenectomy. There was no immediate postoperative complication or mortality. One patient was readmitted after 3 months because of stricture of the bile duct outlet. There was no recurrence over a median follow-up period of 20 months.
CONCLUSION: An appropriate combination of patient positioning and retraction method helps the robot surgical system to provide competent performance for sophisticated and precise manipulation of ampullary lesions.
METHODS: Six patients underwent robotic transduodenal ampullectomy. We employed novel methods to facilitate exposure of the ampulla.
RESULTS: All patients completed robotic transduodenal ampullectomy, but one patient was immediately converted to robotic pancreaticoduodenectomy because of presence of invasive carcinoma on frozen biopsy. The final pathologic report revealed high-grade dysplasia in four patients, low-grade dyplasia in one, and T2N0 in one patient who converted to pancreaticoduodenectomy. There was no immediate postoperative complication or mortality. One patient was readmitted after 3 months because of stricture of the bile duct outlet. There was no recurrence over a median follow-up period of 20 months.
CONCLUSION: An appropriate combination of patient positioning and retraction method helps the robot surgical system to provide competent performance for sophisticated and precise manipulation of ampullary lesions.