Abstract
Background
Radical antegrade modular pancreatosplenectomy (RAMPS) is the standardized approach in open pancreatic resection for pancreatic body and tail cancer. However, few studies have described regarding robotic RAMPS for pancreatic cancer. We herein present our techniques of robotic RAMPS using the supracolic anterior superior mesenteric artery (SMA) approach with the ventral view.
Methods
The patient was a 75-year-old female with a diagnosis of pancreatic body cancer. Following neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel, robotic RAMPS was performed. Our techniques of robotic RAMPS include four steps: (1) gastrocolic ligament division, (2) dissection of superior and inferior border of the pancreas, (3) division of the pancreas, and (4) retroperitoneal dissection.
Results
The operative time was 251 min with an estimated blood loss of 10 mL. The uneventful postoperative course was observed. The final pathology confirmed R0 surgical resection.
Conclusions
Robotic RAMPS using the supracolic anterior SMA approach is safe and feasible for pancreatic body and tail cancer. Standardization and precise anatomical knowledge are key elements of performing robotic RAMPS.
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Acknowledgements
We express our gratitude to Kenjiro Kumano for his suggestions of drawings in this report.
Funding
Financial support was received from Japan Society for the Promotion of Science (grant number 21K16447).
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Supplementary file1 (MP4 295248 KB) Video 1. Robotic RAMPS including four steps: Step 1, Gastrocolic ligament division; Step 2, Dissection of superior and inferior border of the pancreas; Step 3, Division of the pancreas; and Step 4, Retroperitoneal dissection.
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Takagi, K., Umeda, Y., Yoshida, R. et al. Robotic Radical Antegrade Modular Pancreatosplenectomy Using the Supracolic Anterior Superior Mesenteric Artery Approach . J Gastrointest Surg 25, 3015–3018 (2021). https://doi.org/10.1007/s11605-021-05112-z
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DOI: https://doi.org/10.1007/s11605-021-05112-z