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Kauffmann et al. Mini-invasive Surg 2020;4:54 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.46

Original Article Open Access

Robot-assisted spleen preserving distal
pancreatectomy (RA-SPDP): a single center

experience

Emanuele Federico Kauffmann , Niccolò Napoli , Francesca Menonna , Valerio Genovese , Concetta
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Cacace , Cesare Gianfaldoni , Fabio Vistoli , Gabriella Amorese , Ugo Boggi 1
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1 Division of General and Transplant Surgery, University of Pisa, Pisa 56124, Italy.
2 Division of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa 56124, Italy.
Correspondence to: Dr. Emanuele Federico Kauffmann, Division of General and Transplant Surgery, University of Pisa, Via
Paradisa 2, Pisa 56124, Italy. E-mail: emanuele.kauffmann@unipi.it
How to cite this article: Kauffmann EF, Napoli N, Menonna F, Genovese V, Cacace C, Gianfaldoni C, Vistoli F, Amorese G, Boggi U.
Robot-assisted spleen preserving distal pancreatectomy (RA-SPDP): a single center experience. Mini-invasive Surg 2020;4:54.
http://dx.doi.org/10.20517/2574-1225.2020.46
Received: 3 May 2020 First Decision: 26 May 2020 Revised: 31 May 2020 Accepted: 12 Jun 2020 Published: 15 Aug 2020

Academic Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: To define the outcome of robot-assisted spleen preserving distal pancreatectomy (RA-SPDP) in a high-
volume center.

Methods: A retrospective analysis of a prospectively maintained database was performed to identify RA-SPDP
performed at our Center between April 2008 to October 2017.

Results: During the study period, RA-SPDP was attempted in 54 patients. The spleen was preserved, always
along with the splenic vessels (Kimura procedure), in 52 patients (96.3%). There were no conversions to open
or laparoscopic surgery. Mean operative time was 260 min (231.3-360.0). Grade B post-operative pancreatic
fistula (POPF) occurred in 19 patients (35.2%). There were no grade C POPF. Two patients required repeat surgery
because of postoperative bleeding and splenic infarction, respectively. There were no post-operative deaths at
90 days. Excluding one patient with known diagnosis of metastasis from renal cell carcinoma, malignancy was
eventually identified in 7 of 53 patients (13.2%).

Conclusion: In the hands of dedicated pancreatic surgeons, robotic assistance results in a high rate of spleen
preservation with good clinical outcomes. Despite careful preoperative selection, several patients can be found to

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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