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Robotically Assisted, Completely Minimally Invasive Whipple Surgery: Case Study With Video


Since performing San Francisco’s first pure robotically assisted Whipple procedure in 2022, UCSF surgeons continue to be on the forefront of this technology, regularly performing robotic Whipple surgeries (pancreatoduodenectomies) on select patients.

“The robotically assisted Whipple is a very desirable alternative to open surgery for some patients,” said UCSF surgical oncologist Mohamed Adam, MD. “The minimally invasive nature of the procedure means less pain and a reduced healing time for the patient.”

“Robotic pancreatoduodenectomy is an option for most patients with resectable or borderline pancreatic adenocarcinoma or with other pancreatic head or neck pathologies, such as neuroendocrine tumors,” said UCSF surgical oncologist Adnan Alseidi, MD, MEd, FACS. 

Shorter surgical and recovery time

Recently, Adam and Alseidi performed a robotically assisted Whipple procedure on a frail 64-year-old woman with a 2.6-cm neuroendocrine tumor in the uncinate of her pancreas. “Because there was no vascular invasion, she was a good candidate for robotic surgery,” Alseidi said.

The robotic surgery took three and a half hours, and the patient experienced no intraoperative complications and minimal blood loss. This operating time, shorter than the national average for Whipple procedures, was facilitated by UCSF’s two-surgeon team approach. “Our dedicated robotic surgery program was thoughtfully implemented to include two surgeons performing each operation,” Adam said.

The patient had no postoperative complications and no pancreatic connection leak. Even with limited narcotic use, her highest pain score was 5 out of 10 and she was able to walk the day after surgery. Her length of stay was five days. All these factors positively impacted her recovery.

“Her recovery was enhanced by our ERAS–enhanced recovery after surgery – pathway, which allowed her to be home within five days, with minimum discomfort,” Alseidi said. A multidisciplinary team of surgeons, anesthesiologists, nurses and other health care professionals works collaboratively to implement highly effective, evidenced-based interventions and protocols that accelerate patient recovery following surgery. 

“Robotically assisted surgery allows us to make even smaller incisions with greater precision. By using robotic arms, we have more degrees of articulation than with our natural wrists. Ultimately, this translates into more precise surgery with faster recovery,” Alseidi said.

Cancer research and treatment take place within the UCSF Helen Diller Family Comprehensive Cancer Center.

To learn more

UCSF Gastrointestinal Surgical Oncology Clinic
Phone: (415) 502-5577 | Fax: (415) 502-2236
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