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01-02-2015 | Original Article

Robotic Surgery for Benign Duodenal Tumors

Authors: Stephanie Downs-Canner, Wald J. Van der Vliet, Stijn J. J. Thoolen, Brian A. Boone, Amer H. Zureikat, Melissa E. Hogg, David L. Bartlett, Mark P. Callery, Tara S. Kent, Herbert J. Zeh, A. James Moser

Published in: Journal of Gastrointestinal Surgery | Issue 2/2015

Abstract

Introduction

Benign duodenal and periampullary tumors are uncommon lesions requiring careful attention to their complex anatomic relationships with the major and minor papillae as well as the gastric outlet during surgical intervention. While endoscopy is less morbid than open resection, many lesions are not amenable to endoscopic removal. Robotic surgery offers technical advantages above traditional laparoscopy, and we demonstrate the safety and feasibility of this approach for a variety of duodenal lesions.

Methods

We performed a retrospective review of all robotic duodenal resections between April 2010 and December 2013 from two institutions. Demographic, clinicopathologic, and operative details were recorded with special attention to the post-operative course.

Results

Twenty-six patients underwent robotic duodenal resection for a variety of diagnoses. The majority (88 %) were symptomatic at presentation. Nine patients underwent transduodenal ampullectomy, seven patients underwent duodenal resection, six patients underwent transduodenal resection of a mass, and four patients underwent segmental duodenal resection. Median operative time was 4 h with a median estimated blood loss of 50 cm³ and no conversions to an open operation. The rate of major Clavien-Dindo grades 3–4 complications was 15 % at post-operative days 30 and 90 without mortality. Final pathology demonstrated a median tumor size of 2.9 cm with a final histologic diagnoses of adenoma (n = 13), neuroendocrine tumor (n = 6), gastrointestinal stromal tumor (GIST) (n = 2), lipoma (n = 2), Brunner’s gland hamartoma (n = 1), leiomyoma (n = 1), and gangliocytic paraganglioma (n = 1).

Conclusion

Robotic duodenal resection is safe and feasible for benign and premalignant duodenal tumors not amenable to endoscopic resection.

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Title: Robotic Surgery for Benign Duodenal Tumors
Authors: Stephanie Downs-Canner
Wald J. Van der Vliet
Stijn J. J. Thoolen
Brian A. Boone
Amer H. Zureikat
Melissa E. Hogg
David L. Bartlett
Mark P. Callery
Tara S. Kent
Herbert J. Zeh
A. James Moser
Publication date: 01-02-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2668-0

At a glance: The STEP trials

Springer Medicine

Robotic Surgery for Benign Duodenal Tumors

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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