A team of surgeons at Emory University Hospital has recently performed the hospital’s first successful robotic pancreatectomy surgeries using the da Vinci Surgical System.
To date, two robotic pancreatectomies to treat pancreatic tumors have been performed at Emory with excellent results by Dr. David Kooby, who was assisted by fellow Emory surgical oncologist Dr. Shishir Maithel for one procedure and Emory urologist Dr. Kenneth Ogan for the other.
A standard pancreatectomy is the surgical removal of a diseased portion of either the pancreas, or the entire organ. It is typically a treatment option for early-detected pancreatic cancer, or for permanent damage from severe trauma or constant inflammation of the pancreas. The pancreas is a small organ located in the abdomen behind the lower part of the stomach, which produces enzymes that help in digestion, as well as other hormones, such as insulin, which help the body convert sugar to energy.
First performed in the United States in 2007, robotic pancreatectomies provide a level of dexterity not possible with traditional laparoscopic instruments. Using the da Vinci device, Kooby and his colleagues are able to insert a laparoscope and robotic arms through five small incisions in the patient’s abdomen. They then view the operating field in 3-D at a surgical console, using computerized controls to precisely manipulate instruments with a 360-degree range of motion. The procedure culminates with the removal of the pancreas (with or without the spleen) through a two-inch incision. Proponents of robotic surgery feel this technology will provide even better patient outcomes and satisfaction than normal laparoscopy.
Kooby has adopted robotic technology after having conducted notable prospective and retrospective assessments of open and laparoscopic methods of pancreas, liver, and biliary tract resection, collaborating regularly with investigators at Emory and medical facilities around the country, and directed a national study of the efficacy of laparoscopic pancreatectomy from 2002-2006 that concluded that the procedure offered patients shorter hospital stays and fewer complications.
“For me, developing and making robotic pancreatectomy a common clinical practice at Emory was a logical progression. ”The degree of accuracy the robotic method allows would be virtually impossible to replicate otherwise. The technology also makes it easier to preserve the spleen and greatly reduces the complexity of dissection and suturing, Kooby explains.
“While we’re certainly excited by the possibilities of the robotic technology, particularly in terms of patient recovery, we are also very interested in comparing and determining the benefits of robotic versus laparoscopic pancreactectomy,” says Kooby. “We will continue to evaluate the role of the robot in complex pancreatic operations, particularly since the technology appears to provide better dexterity, visualization and confidence in certain circumstances. Our hope is that we will be able to apply the technology to even more complex minimally invasive procedures as we move forward.”