Shukla Ankit, Gnanasekaran Senthil, Kalayarasan Raja, Pottakkat Biju
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
J Minim Invasive Surg. 2022 Dec 15;25(4):145-151. doi: 10.7602/jmis.2022.25.4.145.
Robotic surgery for pancreatic diseases is currently on the rise, feasible, well-accepted, and safe. Frequently performed procedures in relation to pancreatic diseases include distal pancreatectomy and pancreatoduodenectomy. The literature commonly describes robotic lateral pancreaticojejunostomy; however, data on robot-assisted Frey's is scarce.
We herein, describe our series and technique of robot-assisted Frey's procedure at our tertiary care center between November 2019 and March 2022, and its short-term outcomes in comparison to the open Frey's. Patients with chronic pancreatitis having intractable pain, dilated duct, and no evidence of inflammatory head mass or malignancy were included in the study for robot-assisted Frey's.
In our study, out of 32 patients, nine patients underwent robot assisted Frey's procedure. The duration of surgery was significantly longer in robotic group (570 minutes vs. 360 minutes, = 0.003). The medians of intraoperative blood loss and postoperative analgesic requirement were lower in robotic group, but the difference was not statistically significant (250 mL vs. 350 mL, = 0.400 and 3 days vs. 4 days, = 0.200, respectively). The median length of hospital stay was shorter in the robotic group, though not significant (6 days vs. 7 days, = 0.540). At a median follow-up of 28 months, there was no significant difference in the postoperative complications and short-term outcomes between the two groups.
Robotic surgery offers benefits of laparoscopic surgery in addition it has better visualization, magnification, dexterity, and ergonomics. Frey's procedure is possible robotically with acceptable outcomes in selected patients.
目前，用于胰腺疾病的机器人手术正在兴起，可行、被广泛接受且安全。与胰腺疾病相关的常见手术包括胰体尾切除术和胰十二指肠切除术。文献中普遍描述了机器人辅助的胰管空肠侧侧吻合术；然而，关于机器人辅助Frey手术的数据却很少。
在此，我们描述了2019年11月至2022年3月期间在我们的三级医疗中心进行的机器人辅助Frey手术系列病例及技术，以及与开放Frey手术相比的短期结果。纳入研究的机器人辅助Frey手术患者为患有顽固性疼痛、胰管扩张且无炎性肿块或恶性肿瘤证据的慢性胰腺炎患者。
在我们的研究中，32例患者中有9例接受了机器人辅助Frey手术。机器人手术组的手术时间明显更长（570分钟对360分钟，P = 0.003）。机器人手术组的术中失血量中位数和术后镇痛需求较低，但差异无统计学意义（分别为250 mL对350 mL，P = 0.400；3天对4天，P = 0.200）。机器人手术组的住院时间中位数较短，但不显著（6天对7天，P = 0.540）。在中位随访28个月时，两组之间的术后并发症和短期结果无显著差异。
机器人手术除了具有腹腔镜手术的优点外，还具有更好的视野、放大倍数、灵活性和人体工程学。对于选定的患者，机器人辅助Frey手术是可行的，且结果可接受。
