Robotic pancreas surgery allows candidate patients to minimize some of the standard risks and discomfort associated with a standard open operation.

Robotic and Laparoscopic Pancreas Surgery

Robotic pancreas surgery is a minimally invasive form of surgery that can be performed on highly select patients. It reduces some of the discomfort associated with a standard open operation. Don't worry, robotic surgery is performed by surgeons, not robots! The surgeons use the operative robot as an instrument that allows them to make smaller incisions and to cut and suture at angles not possible with human hands. The surgery is typically performed using 3 or 4 half-inch or one-inch incisions, sparing patients a large incision. Fine surgical instruments controlled using a surgical "robot" are used to remove the tumor. As described below, robotic surgery has largely replaced laparoscopic surgery.

Robotic surgery is often preferred over laparoscopic surgery, as robotic surgery overcomes the intrinsic limitations of laparoscopy (long straight tools that do not bend). Since the introduction of robotic pancreatectomy in 2003, many studies have shown that robotic pancreatectomy is a safe procedure for benign and malignant indications. Compared to the open approach, robotic pancreatectomy has demonstrated a reduction in morbidity with significantly decreased incidence of wound complications and the length of postoperative stay while allowing the implementation of enhanced recovery protocols and timely adjuvant treatment.

Since 2015, Johns Hopkins surgeons have performed over 300 robotic pancreatectomy cases, including pancreaticoduodenectomies (Whipple procedures), distal pancreatectomies, and total pancreatectomies. Johns Hopkins has a large fleet of robotic surgery systems and experienced teams to take care of all patients with pancreatic disease.

Pancreas surgery is complex, and a number of published studies have reported that surgery is safest at specialized centers with extensive experience. We therefore recommend that pancreas surgery is performed by a specialist who is familiar with standard tissue handling techniques for the pancreas, and at high volume centers (hospitals that routinely perform large numbers of pancreas surgeries every year).

laparoscopi surgery slides
Laparoscopic Sketch

Benefits of Robotic Pancreas Surgery

  • Less pain
  • Often shorter hospitalization
  • Lower rates of blood transfusion
  • Quicker return to activity and work
  • Lower rates of wound infections and other complications
  • Lower rates of subsequent hernia development
  • Minimal scaring

Who is a Candidate for Robotic Pancreas Surgery?

Robotic surgery is ideal for tumors of the pancreas tail. Candidacy for robotic removal is determined by one of our surgeons reviewing the patient's CAT scan images. Patients are encouraged to call the office of Dr. He to arrange for overnight mailing of CAT scan CD-ROM for them to review. Alternatively, a CAT scan can be performed at the Johns Hopkins Hospital on a same-day basis. Typically a repeat CT scan is needed within 1-2 months prior to surgery.

Drs. He performs the operation using standard cancer principles, obtaining a wide enough removal of the pancreas and surrounding tissue to achieve optimal goals for survival, while minimizing the amount of physiologic stress incurred to the patient.

Larger tumors of any part of the pancreas for which an open operation is required can be started laparoscopically to look for cancer spread before making the large incision - sometimes sparing patients the large incision at a time when comfort is the goal.

A recent article described the robotic surgery program at Hopkins.