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Minimally Invasive Robotic Pancreatic Surgery - Small Wound for Major Pancreatic Surgery

 

Pancreatic surgery, especially pancreaticoduodenectomy or the so-called “Whipple operation”, remains an extremely difficult and challenging procedure. Traditional open pancreaticoduodenectomy (OPD) usually results in a big and painful wound which tortures the patient postoperatively. Therefore, minimally invasive surgery has become a worldwide trend to reduce the wound and mitigate pain. However, it would be nearly  impossible to apply minimally invasive surgery in the tedious and complicated Whipple operation without an experienced and dedicated pancreas team.

 

The pancreas team led by Professor Yi-Ming Shyr and Dr. Shin-E Wang, Chief of Minimally Invasive Surgery have been endeavoring to develop minimally invasive robotic pancreaticoduodenectomy (RPD) at Taipei Veterans General Hospital. Our team has successfully applied the da Vinci Robotic Surgical System in the Whipple operation. With the experience of more than 1,500 Whipple operations and over 380 cases of minimally invasive RPD, our team have made some remarkable records in robotic minimally invasive Whipple operation, including: 1) early discharge from hospital after RPD, as early as on post-operative day 6, about 1 month earlier than that by traditional OPD; 2) minimally invasive wounds, as small as 3 ~ 4 cm by RPD, about 1/10 of the 30~40 cm wound by traditional OPD; 3) “NO” blood loss in 2 cases of RPD, with a mean of 100 c.c., as compared to 500 c.c. blood loss by traditional OPD; 4) short operation time by RPD, as short as 232 minutes (less than 4 hours), shorter than that 6 ~ 8 hours by traditional OPD; 5) successful RPD in a 95 y/o patient, proving RPD to be a feasible option in the very aged patients; 6) low surgical mortality, as low as less than 1%. More than 99% of the patients undergoing minimally invasive RPD are satisfied with our service and would like to recommend this procedure to those with periampullary lesions. There are 67 academic publications related to pancreatic diseases and resection including 1 textbook chapter and 6 papers related to robotic pancreatic resection.With our excellent performance and contribution in the robotic minimally pancreatic surgery, Chief Shin-E Wang was honored to be the speaker in the 13rd World Congress of the International Hepato-Pancreato-Biliary Association (IHPBA) September 6 of 2018. She is also the only Taiwan-representative expert involved in the International Guidelines for Minimally Invasive Pancreatic Resection (IG-MIPR) held at Miami, U.S.A. in March 18 of 2019. Our surgical volume and outcomes of da Vinci robotic minimally invasive RPD have been on the top of Taiwan and also on the leading position in Asia and the World.