Robotic Surgery for Pancreatic Cancer


ATLANTA, Ga. (Ivanhoe Newswire) — Traditional surgery for pancreatic cancer requires a lengthy, open procedure and lots of recovery time. Now, advancements in robotics are making it possible for doctors to operate in this delicate area near the bile ducts and major blood vessels, in a minimally-invasive way.

In 2011, Helen Byrne began having pain in her side. An ultrasound showed kidney stones, and something else; three cysts in her pancreas.

“One in the head of the pancreas. Being a nurse I understood the complexity of what that could mean,” Byrne told Ivanhoe.

The cysts were not cancerous at the time, so for four years, her doctor; Emory Winship Surgical Oncologist David Kooby, kept a watchful eye on them.

“It will turn to cancer at some point; the goal is to get it out before it gets there,” Byrne said.

Helen was one of Dr. Kooby’s first patients to undergo robotic surgery to remove pancreatic cysts. With robotics, Dr. Kooby is able to control tiny instruments and a camera inserted through keyhole incisions in the abdomen.

“I can use one instrument to retract an organ, two instruments to work with. I can decide where the camera is going to be. It has increased stability, and it has binocular vision so I can actually see in three dimension,” David Kooby, MD, Professor of Surgery and Chief of Emory Surgery, Northern Arc, at Emory Winship Cancer Institute explained. (Read Full Interview)

With the robotic surgery, many patients report having less pain, a shorter hospital stay, and a faster recovery.

Dr. Kooby continued, “As we get better at it, and the technology gets better we may see patients get back to chemotherapy faster after surgery.”

“It didn’t slow me down having surgery, hardly at all,” Byrne stated.

Because it requires specialized training and is considered to be a complicated procedure, the robotic surgery for pancreatic cancer is only performed at a handful of major U.S. medical centers. Some of these include Emory, Memorial Sloan Kettering, and University of Southern California.

Contributors to this news report include: Cyndy McGrath, Field and Supervising Producer; Gabriella Battistiol, Assistant Producer; Roque Correa, Videographer and Editor.

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REPORT:       MB #4335

BACKGROUND: Pancreatic cancer starts in the tissue of a patient’s pancreas, which lies horizontally behind the lower part of the stomach, releasing enzymes that aid digestion and hormones that help manage blood sugar. Pancreatic cancer is rarely detected in its early stages, and typically will spread to nearby organs rapidly. For patients with a family history of pancreatic cancer or pancreatic cysts, some screening might help in detecting a problem early on. One sign of pancreatic cancer is diabetes, especially when it occurs side by side with weight loss, pain in the abdomen that spreads to the back, or jaundice. Symptoms may not occur until the advanced stages of the disease, but they may include; depression, blood clots, new-onset diabetes, fatigue, yellowing of skin and whites of the eyes (jaundice,) loss of appetite or unintended weight loss, and pain in the upper abdomen that radiates to the back.


TREATMENT: Treatment options vary based on the patient, and the stage at which the cancer is found. Surgery is an option, removing all or parts of the pancreas depending on the location and size of the tumor; however, an area of healthy tissue is also often removed as a result. Surgery may start with a laparoscopy to find out if the cancer has spread to other parts of the abdomen. Radiation therapy is also an option, using high-energy x-rays or other particles to destroy cancer cells. Finally, chemotherapy, using drugs to destroy the cancer cells by stopping the ability to grow and divide, is another possible treatment. Some drugs approved by the FDA for pancreatic cancer include but are not limited to; Capecitabine (Xeloda), Fluorouracil (5-FU), Irinotecan (Camptosar), Nanoliposomal irinotecan (Onivyde), and Oxaliplatin (Eloxatin).


NEW TECHNOLOGY: “Surgical robotics … is really about getting an improved visualization, additional control. With laparoscopy, I can control two instruments that will rotate back and forth, open and close. With robotics, I can control three instruments and a camera simultaneously. I can use one instrument to retract an organ two others to work with. I can decide where the camera is going to be. It has increased stability, and it has binocular vision. So I can see in three dimensions. And then my instruments not only rotate open and closed but they have wrists. So I can suture much easier, I can do cases that I might not have considered doing minimally invasively with the robotic platform.”

(Sources: David Kooby, MD)


MaryBeth Spence

David Kooby


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