Robotic Distal Pancreatectomy

Background: A robotic-assisted minimal invasive ap-proach has the potential to overcome the limitations of conventional laparoscopic pancreatectomies. We ana-lyzed the outcomes of robotic-assisted distal pancreatec-tomies (RDPs) to demonstrate the safety and feasibility of robotic distal pancreas resection, including spleen preser-vation. Methods: We performed a descriptive retrospective analy-sis of 40 RDPs. Statistical comparisons were performed be-tween two groups of patients undergoing robotic-assisted spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (SDP). Survival analysis was performed using the Kaplan-Meier method. Results: Of 49 attempted RDPs, 40 were completed with robotic assistance, with a conversion rate of 18.4%. Com-pared with the published reports of laparoscopic distal pancreatotomy (DP) and robotic DP, the spleen preserva-tion rate (30%), operating time (203 minutes), major com-plications rate (5%), fistula rate (20%), and length of hos-pital stay (5 days) were similar in our RDP patients. Also, the perioperative outcomes of the SPDP and SDP groups did not differ significantly. The median survival was 12.5 months for the patients undergoing RDP for pancreatic ductal adenocarcinoma. Conclusions: Robotic-assisted distal pancreatectomy, with or without splenic preservation, can be safely per-formed for lesions of the distal pancreas, with appropriate indications. Key Words: Robotic-assisted distal pancreatectomy, Laparoscopic distal pancreatectomy, Spleen-preservin