Robotic Surgery for Benign Duodenal Tumors

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

Research output: Contribution to journalArticle

18 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)306-312
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number2
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Keywords

  • Ampulla
  • Duodenal neoplasm
  • Hepatopancreatic
  • Operative surgical procedure
  • Robotics

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Downs-Canner, S., Van der Vliet, W. J., Thoolen, S. J. J., Boone, B. A., Zureikat, A. H., Hogg, M. E., Bartlett, D. L., Callery, M. P., Kent, T. S., Zeh, H. J., & Moser, A. J. (2015). Robotic Surgery for Benign Duodenal Tumors. Journal of Gastrointestinal Surgery, 19(2), 306-312. https://doi.org/10.1007/s11605-014-2668-0