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Optimizing Robotic Spleen-Preserving Distal Pancreatectomy: Strategies and Innovations to Enhance Safety and Efficacy.
Ann Surg Oncol
September 2025
Hepato‑Biliary and Pancreatic Surgery Unit, Department of Surgery, Hospital del Mar, Pompeu Fabra University, Barcelona, Spain.
Background: Spleen-preserving distal pancreatectomy by robotic surgery is a safe and feasible surgical technique. Currently, spleen-preserving distal pancreatectomy represents an alternative to the classical distal pancreatectomy with splenectomy, in the case of benign and low-grade malignant diseases of the body or pancreas tail. The reasons for preserving the spleen are based on the reduction of postoperative complications, such as post-splenectomy infections, subphrenic abscess, portal thrombosis, pulmonary hypertension, thrombocytosis, and thromboembolism.
View Article and Find Full Text PDFStandard operating procedures and learning curve analysis for surgical assistants in robot-assisted distal pancreatectomy.
J Robot Surg
July 2025
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Wangfujing street, Dongcheng District, Beijing, 100730, China.
Robot-assisted pancreatic surgery (RPS) is increasingly adopted across institutions. While structured training and longitudinal skill acquisition are essential for optimal outcomes, the learning progression of surgical assistants in RPS remains inadequately characterized. This study presents our institution's standard operating procedures (SOP) for robot-assisted distal pancreatectomy (RDP) developed through a single-team cohort experience and defines the assistant learning curve based on operative time, thereby establishing evidence-based benchmarks for RPS training programs.
View Article and Find Full Text PDFASO Author Reflections: Patient Selection and Technique for Robotic Spleen-Preserving Distal Pancreatectomy.
Ann Surg Oncol
September 2025
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
Spleen-preserving distal pancreatectomy is an increasingly preferred approach for patients with multiple endocrine neoplasia type 1 (MEN1) and pancreatic neuroendocrine tumors (pNETs), offering potential long-term benefits, such as preserved immunologic function and reduced thromboembolic or oncologic risks. While traditional distal pancreatectomy with splenectomy facilitates lymph node clearance, it carries significant short- and long-term complications. In our recently published video, we demonstrate a robotic spleen-preserving distal pancreatectomy using the Kimura technique in two patients with MEN1 and multifocal pNETs.
View Article and Find Full Text PDFMinimally Invasive Spleen-Preserving Distal Pancreatectomy in Obese Patients: Factors Related to Clinically Relevant Pancreatic Fistula.
Int J Med Robot
August 2025
Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.
Background: Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP.
Methods: A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches.
Robotic Spleen-Preserving Distal Pancreatectomy for Pancreatic Neuroendocrine Tumors in Multiple Endocrine Neoplasia Type 1.
Ann Surg Oncol
September 2025
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.