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 HOW I DO IT
Year : 2021  |  Volume : 17  |  Issue : 3  |  Page : 399-404

The technique of precise and systematic vascular control during robotic pancreaticoduodenectomy for periampullary and pancreatic tumours


Department of Surgical Gastroenterology, Jawaharlal Institute of Post graduate Medical Education and Research, Puducherry, India

Correspondence Address:
Dr. Raja Kalayarasan
Department of Surgical Gastroenterology, Jawaharlal Institute of Post graduate Medical Education and Research, Puducherry - 605 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_239_20

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Robotic pancreaticoduodenectomy (PD) remains one of the most advanced robotic procedures. Improved ergonomics and stable 3D vision with robotic platform helped overcome the technical challenges of pancreatic reconstruction in minimally invasive PD. However, inadequate understanding of the complex vascular anatomy of the pancreatic head and uncinate process often results in intra-operative bleeding and prolongs the learning curve. The technique of precise identification and systematic control of the vessels supplying the head and the uncinate process is described in this report. A good understanding of the common vascular anatomy and variations along with stepwise precise vascular control described in this report could minimise intra-operative bleeding and shorten the learning curve associated with robotic PD.






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