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Robotic spleen preserving distal pancreatectomy in pediatric patient. Case report

Robotic spleen preserving distal pancreatectomy in pediatric patient. Case report. Young Ju Hong M.D., Seonae Ryu , Hye Kyung Chang M.D., Jung Tak Oh M.D., Seok Joo Han M.D. Department of Pediatric Surgery Severance Children`s Hospital Department of Surgery

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Robotic spleen preserving distal pancreatectomy in pediatric patient. Case report

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  1. Robotic spleen preserving distal pancreatectomyin pediatric patient.Case report Young Ju Hong M.D., SeonaeRyu, Hye Kyung Chang M.D., Jung Tak Oh M.D., SeokJoo Han M.D. Department of Pediatric Surgery Severance Children`s Hospital Department of Surgery Yonsei University College of Medicine

  2. Background Solid papillary neoplasm • rare pancreatic neoplasm (1~3% of primary pancreatic tumors) • >80% : female, 85% : less than 30 years old • With surgical complete excision 5 YSR : 95 % • Aggressive variants : represent malignant degeneration in an otherwise indolent tumor • Surgical resection is indicated in all instances Yonsei University Health System

  3. Background Minimally invasive surgery for pancreatic tumor • 1996 first laparoscopic distal pancreatectomy • Low grade tumor, young patient : choice • Splenic preservation : useful, especially in children da Vinci robot system • 3D magnified field of view • Precise and multi-articulated handlike motions • Hand-tremor filtering system • Ergonomically designed operative space Yonsei University Health System

  4. Case – History of illness • F/16 • C.C : low abdominal pain (duration : 2 weeks) • Laboratory test 4800(33%) 12.5/37.4 308K Amylase/lipase 74/25 CEA 0.91 CA 19-9 1.5 Yonsei University Health System

  5. Case – MRI

  6. Case – MRI

  7. Case – PET CT

  8. Case – Operation

  9. Case – Pathology • Solid pseudopapillary tumor • size : 1x0.8cm • Mitosis : 3/10 HPF • LVI : not identified • Resection margin : free from tumor • IH stain • Vimentin and beta-catenin : positive • CD 10 : focally and weakly positive • Chromogranin A : Negative

  10. Case – Progress • POD 2 : gas out(+), SOW • POD 4 : soft diet • POD 5 : Lab : WNL, CT • POD 8 : discharge

  11. Conclusion Robotic spleen preserving distal pancreatectomy in pediatric patient • Safe • Feasible treatment option that preserves splenic function for benign or low grade malignant tumor of the distal pancreas Yonsei University Health System

  12. Thank you for your attention

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