Robotic Pancreatic Surgery
Whereas some laparoscopic procedures of the pancreas have rapidly emerged as good alternatives to open surgery, major laparoscopic resections of the pancreas, including distal pancreatectomy are being adopted at a rather slower pace and seem confined to a few selected centers. Among the reasons for the slower acceptance are concerns about whether it is an adequate cancer operation as well as technical difficulties that require a highly skilled laparoscopic surgeon.
Robotic surgery has successfully addressed the limitations of traditional laparoscopic surgery, thus allowing completion of complex and advanced surgical procedures with increased precision in a minimally invasive approach. In contrast to the awkward positions that are required for laparoscopic surgery, the surgeon is seated comfortably on the robotic control consol, an arrangement that reduces the surgeon's physical burden. Instead of the flat, two-dimensional image that is obtained through the regular laparoscopic camera, the surgeon receives a three-dimensional view that enhances depth perception; camera motion is steady and conveniently controlled by the operating surgeon with a manual master control. Also manipulation of robotic arm instruments, endowristed at the tip, improves range of motion (360 degrees) allowing the surgeon to perform more complex surgical movements. In particular, in pancreatic surgery robotic technology provides evident advantages in regard to better micro-dissection along major vessels allowing for spleen-preservation if feasible and technically superior suturing.
The practical results of these features are decreased blood losses, better lympadenectomy with improved radicality, less conversion rate, less surgical trauma.