Whipple’s procedure or pancreatic oduodenectomy is a major gastrointestinal surgery done for tumor of pancreas. This surgery may be done by open, laparoscopic or robotic approach. It is already known that GEM Hospital has performed the largest series of laparoscopic whipple’s procedure in the world and has published this in world literature.
In fact, the same procedure has been done by laparoscopy in a 12 year old girl in 2014 at Gem hospital and it has been reported as the youngest patient in the world to undergo this major Whipples’s operation by laparoscopy. The advantages of performing this major surgery by laparoscopy include absence of large incision, lesser pain, decreased blood loss, quicker discharge from hospital and faster return to work.
In addition to all these, the robotic approach provides high precision in surgery with better clearance of tumor advantages like 3d vision, enhanced degrees of freedom of movement upto 540 degrees, greater precision of anastomosis, filtering of tremor, improved surgeon comfort with better ergonomics. GEM Robotic surgery has ICG fluorescence which facilitates mapping of spread of tumor lymphatics and nodes.
This patient is a 14 year old girl from Coimbatore who had been evaluated outside and referred to our centre for whipples procedure for pancreatic tumor. This tumor was 7 cm in the head of pancreas called as solid pseudo papillary tumor of pancreas, which is common in young females in early 20s. Robotic whipple’s operation was successfully performed on this patient.
The operative team included Prof. C.Palanivelu(chief surgeon), Dr. P. Senthilnathan, Dr. N.Anand Vijai, Dr. S.Srivatsan and Dr. Vivek (Anaesthetist). The procedure was performed using the Da vinci Si robotic system. The duration of the procedure was close to 5 hours and it was done in a bloodless manner, hence no blood transfusion was given. The patient had a very quick post-operative recovery. Enteral feeding was started on 2nd post op day. Patient was discharged as early as 5th post op day with no scars. Patient is on normal diet.
The biopsy of the tumour confirmed that it was solid pseudo papillary tumor of pancreas. This is the youngest patient in the world to undergo this major procedure by robotic approach.