Robotic pancreatectomy speeds recovery time

Johnny Cleveland thought he was having a heart attack when he went to a community hospital, but medical imaging revealed something suspicious with his pancreas. 

The retired educator from Red Bay, Alabama, then went to Birmingham for more testing where he was diagnosed with an intraductal papillary mucinous neoplasm — a cyst in the duct of his pancreas that put him at very high risk for pancreatic cancer. The duct had swollen to four times its normal size. Cleveland knew he needed complicated surgery, so researching his options, he learned about the Vanderbilt surgical team led by Kamran Idrees, MD, MSCI, MMHC, Ingram Associate Professor of Cancer Research. 

Idrees, chief of the division of Surgical Oncology and Endocrine Surgery, specializes in difficult-to-perform procedures. His patients include those with pancreatic and other abdominal cancers, as well as premalignant conditions, who have been told their tumors are inoperable. Cleveland went to his initial appointment with Idrees expecting to hear about wide incisions, an extended hospitalization and a long recovery time. 

Even though he had a total pancreatectomy — which in his case entailed removing his whole pancreas along with his gallbladder, spleen, duodenum, parts of the stomach and bile duct — Cleveland had only small incisions with no wide cuts. Idrees, working alongside Sekhar Padmanabhan, MD, assistant professor of Surgery, performed the pancreatectomy utilizing robotic technology. They then created two separate connections, one between the bile duct and small intestine, and a second connection between the stomach and the small intestine robotically. 

Robotic surgery requires a highly skilled surgeon, who, from a console, uses a powerful camera to see inside the body and controls miniature surgical instruments that can be rotated in ways beyond the dexterity of the human hand.  

“I had seven holes produced instead of being cut from side to side and split up and down,” Cleveland said. “My hospital stay was very minimal. It was five days instead of 10-14.” 

Idrees has utilized robotic technology for pancreas surgeries since 2019 and has performed more than 100 procedures with colleagues. However, Cleveland was his first patient to undergo a total pancreatectomy utilizing robotic surgery. 

Pancreatic surgeries are performed to address premalignant conditions and cancer. 

“Robotic surgery offers the advantages of quicker recovery time, shorter length of stay, quick healing and less pain medication requirements,” Idrees said.