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Basso et al. Mini-invasive Surg 2017;1:133-42 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.06
www.misjournal.net
Original Article Open Access

Mini-invasive distal pancreatectomy: a

feasible and cost-effective technique

Stefano Maria Massimiliano Basso , Federica Maffeis , Franco Lumachi , Alessandro Patanè ,
1,2
3
1,2
1
Michele Ciocca Vasino , Paolo Ubiali 1,2
2
1 Department of Surgery, General Surgery, S. Maria degli Angeli Hospital, Via Montereale 24, 33170 Pordenone, Italy.
2 Department of Oncologic Surgery, Humanitas Gavazzeni Institute, Via Mauro Gavazzeni 21, 24125 Bergamo, Italy.
3 Department of Surgery, Oncology and Gastroenterology, University of Padua, School of Medicine, 35128 Padova, Italy.
Correspondence to: Dr. Stefano Maria Massimiliano Basso, Department of Surgery, General Surgery, S. Maria degli Angeli Hospital, Via Montereale 24,
33170 Pordenone, Italy. E-mail: Drsteba@tin.it
How to cite this article: Basso SMM, Maffeis F, Lumachi F, Patanè A, Ciocca Vasino M, Ubiali P. Mini-invasive distal pancreatectomy: a feasible
and cost-effective technique. Mini-invasive Surg 2017;1:133-42.
ABSTRACT
Article history: Aim: Laparoscopic pancreatic surgery is a minimally invasive technique that has been widely
Received: 23 Feb 2017 applied only in the past decade. The purpose of this study was to evaluate its safety and assess
Accepted: 22 May 2017 whether laparoscopic distal pancreatectomy (LDP) is cost-effective compared with open
Published: 30 Sep 2017 distal pancreatectomy (ODP). Methods: The medical records of patients treated for left-
sided pancreatic lesions were retrospectively analysed, and the analysis of costs for hospital
Key words: stay, operative time, and equipment were analysed. Twelve patients underwent LDP, while
Mini-invasive, 12 patients underwent ODP. Results: The two groups were homogeneous according to age,
distal pancreatectomy, ASA score, BMI, and distribution of pathological findings. Both the size of the specimen
laparoscopy, (5.33 ± 3.2 vs. 5.58 ± 2.57 cm) and the number of removed lymph nodes (10.5 ± 4.3 vs. 12.1
cost ± 3.1) did not differ. Although LDP required a longer operative time (197.5 ± 33.7 vs. 122.5
± 35.4 min), intraoperative bleeding, postoperative pain intensity (measured by VAS scale)
and hospital stay were significantly reduced. Conclusion: The mini-invasive approach offers
several advantages compared with open surgery, including a significant reduction of blood
loss and postoperative pain, and an earlier recovery. The global costs of laparoscopic surgery
should be carefully re-evaluated, considering the saving that arises from these advantages.

INTRODUCTION the pancreas is still challenging, and although the first
reported case of laparoscopic approach in pancreatic
Advances in laparoscopic technologies have greatly disease was in 1994, it has been widely applied only
expanded the use of this technique in general surgery. in the past decade. [3-5] Open surgery is still performed
The benefits of laparoscopic or minimally invasive because of the anatomy of pancreas, limitations
surgery (better cosmesis, reduced postoperative pain, of team skills, and some early concerns regarding
and faster recovery) are well known for many diseases, oncologic outcomes. [6] Nevertheless, minimally
but reduced trauma to the abdominal wall is particularly invasive surgery has been increasingly adopted,
evident in pancreatic surgery. [1,2] However, surgery of particularly for benign or low-malignancy pancreatic

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