Robot-Assisted Spleen-Preserving Distal Pancreatectomy

Pier C. Giulianotti (Chicago – USA)

SUMMARY: The pneumoperitoneum is induced with the Verres needle.
The abdominal exploration does not show carcinomatosis and liver metastases.
The lesser sac is entered by dividing the gastrocolic ligament and preserving the gastroepiploic artery. The stomach is then retracted cephalad. The splenic flexure is taken down to expose the pancreatic tail and the cystic tumor. The splenic artery and vein branches and tributaries are dissected and divided betwenn sutures. Once the tail is mobilized, the neck of the pancreas is transected using ultrasonic shears and reinforced with 4–0 Prolene mattress sutures on the proximal pancreatic remnant, paying special attention to the pancreatic duct, in order to minimize the incidence of pancreatic leak. The specimen is removed with an endobag and a suction drain is routinely left in place.