Full Robotic Pancreatoduodenectomy
October 16, 2012
A. Coratti , M. Annecchiarico, F. Coratti, M. Di Marino
The Robot is docked head on from the patient’s head.
The procedure is started by sectioning the gastro-colic ligament.
The pancreas is accessed and the inferior margin is dissected.
Lymphadenectomy of the retropyloric and retropancreatic stations is carried out.
Follwoing this step, Kocher manouver is performed: The vena cava and the left renal vein are identified. The duodenum is then sectioned.
Lymphadenectomy of the hepatic hilum id carried out. The retropancreatic passage is opened and after mobilization of the Treiz the duodenum is reached. Pancreas is sectioend with ultrasound energy scalpel and uncinate process dissected.
Due to the pancreatic tissue fragility and the small calibre of the pancreatic duct this reconstructive part was performed as a pancreato-gastrostomy. Hepatico-jejunostomy and duodeno-jejnostomy on single small bowel loop completed the reconstruction.