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 Yonsei University College of Medicine
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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 SurgerySeverance Children`s Hospital
Department of SurgeryYonsei University College of Medicine
Yonsei University Health System
Background
Solid papillary neoplasm rare pancreatic neoplasm (1~3% of primary pancreatic tu-
mors)
>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
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
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
Case – MRI
Case – MRI
Case – PET CT
Case – Operation
Case – Pathology
Solid pseudopapillary tu-mor– 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
Case – Progress
POD 2 : gas out(+), SOW POD 4 : soft diet POD 5 : Lab : WNL, CT POD 8 : discharge
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
Conclusion
Thank you for your attention
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