Pancreatic cancer has in new robotic surgery treatment option
The pancreas is a vital organ located in the abdominal cavity just behind the stomach. It plays a key role in the digestion process by secreting important enzymes and also regulates the production and release of insulin. Several diseases can affect the pancreas, some of them being of clinical treatment, and others that can be treated surgically, such as cancer. With high mortality, pancreatic cancer has experienced a significant increase in its incidence in the last years, with high mortality, and complete surgical resection represents today the main chance of cure for the patient.
The first radical surgery of the pancreas was performed in 1899 and since then, several studies and studies have been trying to improve the surgical technique and its results, in order to provide lower rates of complications and longer longevity with quality of life to the patient.
Because it is a highly complex surgery , with several potential complications, only teams specializing in pancreatic surgery can achieve satisfactory results. However, the large surgical incisions of the conventional procedures (cut-out surgery), associated with the extensive surgical trauma, provide a slow recovery with long hospital stay and significant postoperative pain.
Indeed, after more than 100 years of discrete advances in this area, the use of high technology robotic surgery promises to be the biggest revolution in the advancement of pancreatic surgery. By means of small surgical incisions, the tweezers and instruments of the robot-surgeon are positioned in the abdominal cavity of the patient and, with precise and controlled movements, the surgeon's commands are reproduced almost in an artistic way, being possible to perform any type of surgery in the pancreas.
Duodenum-pancreatectomy (removal of the head from the pancreas and intestinal segment), which was always a major surgical challenge even to experienced surgeons, was not performed in a minimally invasive manner due to its high complexity and great technical difficulty with usual videolaparoscopy. However, after the use of robotic technology, it was possible to perform large pancreatic surgeries without the giant abdominal incisions of open surgery.
Five years ago the first minimally invasive robotic duodenum-pancreatectomy in Latin America was performed at Israelita Albert Einstein Hospital. Since then, several patients have been able to benefit from robotic pancreatic surgery with excellent results, less postoperative pain and with an earlier return to their usual activities. There is a need for much training and dedication to perform surgery of this size. However, the benefit to the patient is indisputable and therefore justifies all the effort.
* Text written in co-authoring with Dr. Jacques Matone - surgeon of the Hospital Israelita Albert Einstein.
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