Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, Suite 435E, Chicago, IL 60612, USA.
Surg Endosc. 2010 Jul;24(7):1646-57. doi: 10.1007/s00464-009-0825-4. Epub 2010 Jan 9.
Use of robotic surgery has gained increasing acceptance over the last few years. There are few reports, however, on advanced pancreatic robotic surgery. In fact, the indication for robotic surgery in pancreatic disease has been controversial. This paper retrospectively reviews one surgeon's experience with robotic surgery to treat pancreatic disease, and analyzes its indications and outcomes, as well as the controversy that exists.
A retrospective review of the charts of all patients who underwent robotic surgery for pancreatic disease by a single surgeon at two different institutions was carried out.
From October 2000 to January 2009, 134 patients underwent robotic-assisted surgery for different pancreatic pathologies. All procedures were performed using the da Vinci robotic system. Of the 134 patients, 83 were female. The average age of all patients was 57 years (range 24-86 years). Mean operating room (OR) time was 331 min (75-660 min). There were 14 conversions to open surgery. Mean length of stay was 9.3 days (3-85 days). Length of stay for patients with no complications was 7.9 days (3-15 days). The postoperative morbidity rate was 26% and the mortality rate was 2.23% (three patients). Among the procedures performed were 60 pancreaticoduodenectomies, 23 spleen-preserving distal pancreatectomies, 23 splenopancreatectomies, 3 middle pancreatectomies, 1 total pancreatectomy, and 3 enucleations. Another 21 patients underwent different surgical procedures for treatment of acute and chronic pancreatitis. Two cases of pancreaticoduodenectomy were performed in outside institutions and are not included in this series.
This is the largest series of robotic pancreatic surgery presented to date. Robotic surgery enables difficult technical maneuvers to be performed that facilitate the success of pancreatic minimally invasive surgery. The results in this series demonstrate that it is feasible and safe. Complication and mortality rates are comparable to those of open surgery but with the advantages of minimally invasive surgery.
机器人手术在过去几年中得到了越来越多的认可。然而，关于胰腺机器人手术的报道很少。事实上，机器人手术在胰腺疾病中的适应证一直存在争议。本文回顾了一位外科医生应用机器人手术治疗胰腺疾病的经验，分析了其适应证和结果，以及存在的争议。
对一位外科医生在两家不同机构应用机器人手术治疗胰腺疾病的所有患者的病历进行回顾性分析。
从 2000 年 10 月至 2009 年 1 月，共有 134 例不同胰腺疾病患者接受了机器人辅助手术。所有手术均采用达芬奇机器人系统完成。134 例患者中，女性 83 例。所有患者的平均年龄为 57 岁（24-86 岁）。平均手术间时间为 331 分钟（75-660 分钟）。有 14 例转为开腹手术。平均住院时间为 9.3 天（3-85 天）。无并发症患者的住院时间为 7.9 天（3-15 天）。术后发病率为 26%，死亡率为 2.23%（3 例）。手术方式包括胰十二指肠切除术 60 例，保留脾脏的胰体尾切除术 23 例，胰体尾脾切除术 23 例，中段胰腺切除术 3 例，全胰腺切除术 1 例，肿瘤剜除术 3 例。另有 21 例患者接受了不同的手术治疗急性和慢性胰腺炎。在其他机构进行的 2 例胰十二指肠切除术未包含在本系列中。
这是迄今为止报道的最大的机器人胰腺手术系列。机器人手术能够完成困难的技术操作，有助于微创胰腺手术的成功。本系列结果表明其是可行和安全的。并发症和死亡率与开腹手术相当，但具有微创外科的优势。
