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250 Robotic Assisted Major Pancreatic Resections
Herbert J Zeh, III*1, Brian A Boone*1, Arthur James Moser*2, David L Bartlett1, Amer H Zuriekat*1
1University of Pittsburgh, Pittsburgh, PA;2BIDMC, Harvard, Boston, PA

Objectives: Robotic-assisted allows complex resections and anastomotic reconstructions to be performed with identical standards to open surgery. We have applied this technology to a variety of major pancreatic resections in order to assess the safety, utility and efficacy of this platform.
Methods: A retrospective review of a prospectively maintained database of robotic assisted pancreatic resections at a single institution between August 2008 and November 2012 was performed. Preoperative, operative, pathologic, and post-operative outcomes were analyzed
Results: 250 consecutive robotic assisted major pancreatic resections were analyzed; pancreaticoduodenectomy (PD =132), distal pancreatectomy (DP=83), central pancreatectomy (CP=13), pancreatic enucleation (10), total pancreatectomy (5), Appleby resection (4), and Frey procedure (3). Mean operative time for the two most common procedures was 529 ± 103 mins for PD, and 257 ± 93 mins for DP (last 50 PD 444 (+/- 76 mins), DP 222 +/- 73 mins). Conversion to open procedure in 16 patients (6%);(11 PD, 2 DP, 2 CP, 1 TP) failure to progress (14) and bleeding (2). 90 day mortality was (4) 1.8% for the 225 subjects with at least 90 day follow up.
Conclusions: This represents to our knowledge the largest series of robotic assisted pancreatic resections. The safety metric outcomes, including the low incidence of conversion, support the robustness of this platform when applied to pancreatic procedures.
Patient Characteristics
Age, median(range)65 (18-90)
Female, n(%)128 (51%)
BMI, median(IQR)27.5 (24-32)
Prior Surgery, n(%)129 (52%)
ASA score, n (%)
2
3
4
72 (29%)
169 (68%)
9 (4%)
Indication, n(%)
Pancreatic adenocarcinoma
Periampullary carcinoma
Neuroendocrine tumor
Premalignant
Benign
77 (31%)
43(17%)
58(23%)
52(21%)
20(8%)


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