Technique for laparobotic distal pancreatectomy with preservation of spleen.

Minimally invasive surgery for pancreas has advanced at a steady pace in recent years. Although proximal pancreatic resection is still a formidable task, distal resection has become routine with a laparoscopic approach. The recent introduction of the Da Vinci Robotic Surgical System has helped to make this complex procedure much more feasible, efficient, and safe. In this paper, we describe our technique for robot-assisted distal pancreatectomy with splenic preservation, which can be broken down into five steps in a medial-to-lateral progression. Preservation of splenic vessels is routine, although in certain instances a Warshaw's technique is employed. The advantages of the robotic approach are described.