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Robotic Distal Pancreatectomy with Splenic Preservation

Robotic distal pancreatectomy with splenic preservation is a minimally invasive surgical option for benign-borderline tumors of the pancreatic body-tail.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Robotic Distal Pancreatectomy with Splenic Preservation?

Robotic distal pancreatectomy is the minimally invasive standard for benign-borderline tumors of the pancreatic body-tail. Splenic preservation provides better immune function (especially against encapsulated bacteria) and prevents splenectomy-related complications.

Indications: pancreatic neuroendocrine tumor (PNET) <3 cm non-functional or insulinoma, mucinous cystic neoplasm (MCN), serous cystadenoma, IPMN (branch-duct), solid pseudopapillary tumor (SPT), low-grade ductal lesions. Contraindications: ductal adenocarcinoma (oncologic radical splenectomy + LND).

Two main techniques: Kimura — splenic artery and vein preservation, the gold standard but technically more difficult; ~80% success. Warshaw — splenic vessels are ligated, splenic perfusion is provided through short gastric and gastroepiploic vessels; technically easier, 10-20% splenic infarction risk. Robotic platform 7-DOF instruments + 3D vision are advantageous for splenic vessel dissection. Operative time 3-4 hours, hospital stay 5-7 days, POPF rate 15-25%.

Symptoms

Mostly asymptomatic (incidental detection)
Vague abdominal pain
Insulinoma: hypoglycemia (Whipple triad)
Gastrinoma: peptic ulcer, diarrhea (Zollinger-Ellison)
Mass effect (large lesions)
Weight loss (rare)

Risk Factors

MEN1 syndrome (PNET multifocal)
Von Hippel-Lindau syndrome
Family history of pancreatic cancer
Chronic pancreatitis
Female gender (MCN, SPT)
Age 40-60 (PNET, IPMN)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Incidental pancreatic mass on imaging
  • Hypoglycemia symptoms (Whipple triad)
  • Peptic ulcer + diarrhea (Zollinger)
  • Vague abdominal pain + weight loss
  • MEN1 family screening
  • Pancreatic cyst follow-up

Treatment Methods

01
Pre-op CT/MRI/EUS + biopsy
02
Functional tumor: hormonal stabilization
03
Robotic platform (DaVinci Xi/SP)
04
Kimura (splenic vessel preservation, gold standard)
05
Warshaw (vessel ligation, technically easier)
06
Postop: drain monitoring (POPF), pneumococcal vaccination if splenectomy

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.