Zentralblatt fur Chirurgie · 2022
[Robotic-assisted Enucleation of a Cystic Neoplasm in the Head of the Pancreas].
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Litkevych Stanislav, Thomaschewski Michael, Zimmermann Markus, Wellner Ulrich Friedrich, Höppner Jens, Keck Tobias
Аннотация
According to current revised Fukuoka guidelines, there is an indication for resection of BD-IPMN of the pancreas with "worrisome features", as there is a risk of malignant degeneration of up to 30%. This can be performed as a non-anatomical local excision in the absence of clinical, radiological and laboratory signs of malignancy.Robotic enucleation for benign tumours of the pancreas is a very good alternative to resecting procedures, especially those using open techniques. This surgical treatment option is recommended by the "International consensus statement on robotic pancreatic surgery" in a case of a minimum distance to the main pancreatic duct of at least 2 mm.In addition to the known advantages of minimally invasive surgery, this parenchyma-sparing approach results in preservation of endo- and exocrine function (ca. 90%) and 10-year progression-free survival of ca. 75% with slightly increased morbidity (ca. 60%) compared with resecting procedures.The following video article presents the surgical video of a robotic cyst enucleation (for suspected BD-IPMN with "worrisome features") in the pancreatic head and uncinate process in a 62-year-old female patient with special emphasis on the most important vascular landmarks, special features of the approach and advantages of the robotic technique.