Surgeons now use minimally invasive robotic surgical system for Whipple procedure

Loyola University Health SystemFeb 11 2014

The Whipple procedure, used to remove tumors from pancreatic cancer patients, is one of surgery's most extensive and challenging operations.

Now, surgeons are using a minimally invasive robotic surgical system to perform the surgery.

Loyola University Medical Center is among the first hospitals to perform the Whipple procedure with a robotic system. Loyola also recently became one of the first hospitals to use the robotic system for rectal cancer surgery.

The Whipple procedure, also called a pancreatoduodenectomy, treats pancreatic cancer. It involves removal of the head of the pancreas, the gall bladder, the duodenum (first section of the small intestine), the common bile duct and sometimes part of the stomach. The surgeon then reconstructs the digestive tract.

Conventional open surgery requires an incision 8 to 10 cm. long or longer. The robotic system requires only a 3 cm. incision, plus a few incisions less than a centimeter wide. This less invasive approach could result in faster recovery, less pain, less blood loss, less stress on the immune system and fewer pain medications.

Sam Pappas, MD, and Gerard Abood, MD, partners in the Division of Surgical Oncology, recently used the robotic system to perform a Whipple procedure on a patient who had a precancerous tumor that was discovered after an attack of pancreatitis. The patient went home after six days and likely is cured.

Dr. Pappas and Dr. Abood also are using advanced, minimally invasive and robotic techniques for other tumors of the pancreas, liver, bile duct, esophagus and stomach. The goal is to allow the potentially safest and fastest recovery and to enable the patient to resume additional cancer therapies.

Dana Hayden, MD, recently used the robotic system to perform an abdomioperineal resection on a patient with an extremely low rectal cancer. Dr. Hayden removed the patient's anus, rectum and sigmoid colon. She then created a stoma (opening), in which waste can be removed from the body.

The specimen was removed through the perineum. Only five small abdominal incisions - between 5 mm and 1 cm - were needed. The patient went home after four days, and is doing very well.

The robotic surgery is less invasive than open surgery - the largest incision is only 1 cm. long. And it provides dramatically better visualization during deep pelvic operations, Dr. Hayden said.