El Chuac removes a pancreatic cancer with robotic technology for the first time in Galicia

The University Hospital A Corua has used for the first time in Galicia robotic technology to remove a pancreatic cancer. The patient is a 60 year old woman that he has already received a medical discharge and that he is recovering at home. Its evolution, according to what the center pointed out, is satisfactory.

The cephalic duodenopancreatectomy, which is the name of the operation performed, consists of the removal of the head of the pancreas, duodenum, a small segment of stomach, gallbladder and extrahepatic bile duct, as well as lymph nodes in the areawho in this case were affected by cancer.

The specialists stress that it is the most complex surgical technique of all hepato-bilio-pancreatic pathology, hence the most common way to approach it is through conventional open surgery and, more exceptionally, with laparoscopic surgery.

In this case. Chuac’s general surgery team took advantage of the advantages provided by the davinci robot to carry out this technique for the first time in Galicia. The intervention was carried out laparoscopically, taking advantage of the magnified vision provided by technology, since the visual field is magnified up to 10 times. The surgeon operates the camera with the robot, so the view of the surgical field is very stable, hand tremor is eliminated and also benefits from the turning capacity of surgical forcepsmuch more limited in conventional laparoscopy.

The complexity of this surgical technique consists not only in the extirpation of the entire piece affected by the cancer, which is technically very difficult due to its relationship with large vessels, but also in the difficulty of removing it. reconstruction of organs and tissues that are around the pancreas, due to the proximity of important veins and arteries, they explain from the hospital.

Robotic laparoscopic surgery can be applied to any endoscopic intervention, but in the case of Chuac, surgeons have decided to use it in highly complex operations, such as colorectal, digestive or pancreatic cancer, as on this occasion.

Since the launch of the Da Vinci robot. the Chuac general surgery service has already carried out 337 operations. In all these indications, the robotic solution improves the already known benefits of minimally invasive surgery, they point out, which is reflected in a better and faster recovery of the patient, the reduction of post-surgical complications and, consequently, the faster return to surgery. your usual activity.

This is like taking the last step, like climb the last rung of the laddervalues ​​Xavier aguirrezabalaga González (Pontevedra, 1967), the surgeon who operated the robot’s console, about a very difficult intervention because the head of the pancreas is attached to very large vessels and, in addition, many tissues must be reconstructed, joined and sutured afterwards, he emphasizes. An idea of ​​the complexity is given by the fact that normally these cases are done with open surgery, in a few places by laparoscopy and with a robot in even fewer.

The operation carried out is, then, the evolution derived from a robotic activity that the digestive surgeons of Chuac initiated in October 2021 and that currently has already routinely incorporated the performance of other operations, such as liver operations.

Behind it is not only the experience in open and laparoscopic surgery of many years, but before facing the challenge of removing the pancreatic tumor we went to see how they did it in other centers, we attended specific meetings and asked for advice from experienced surgeons, explains Aguirrezabalaga, who details that the longest series of cases in the few centers carried out in Spain is in Barcelona.

Five hours used to remove stage I pancreatic cancer, when by open surgery there are slightly more than four, it is important because the first thing is patient safety, you can’t jump into a nine-hour surgery, explains the specialist, who appreciates that such a small difference in time means that the entire team was prepared; are are team interventions, the nurse has to control the robot very well, the anesthetist, the assistants… The patient remained hospitalized for about two weeks, one less than with the conventional technique, a period that will probably be reduced to one week-ten days in the following cases.

Having the Da Vinci, in his opinion, facilitates surgical practice in several aspects, among them the quality of vision, it is magnified tenfold, we see vessels that we are not able to see with open surgery, which allows you to tie them, cauterize , control bleeding… and with a camera that the surgeon handles but mobilizes the robot, so it never moves, it is stable, which gives a lot of peace of mind. The technology itself also removes the tremor if at any given moment you get nervous, and that gives a lot of security when sewing a glass or if bleeding occurs. Added to this, Aguirrezabalaga added the advantage of remotely operating surgical forceps that are not straight as in laparoscopy and rotate almost 360 degrees, allowing you to perform many more maneuvers. In addition, you operate sitting down, it is much more comfortablepoint.

Although not all cases can be treated with Da Vinci, gastroenterologists consider that its application will increase in tumors such as the one operated on last April, since there is an increasing incidence of pancreatic cancer. Only in Chuac, they calculate that annually there will be between 35 and 40 patients, but they anticipate that its application will be generalized.

This is already the present, says the surgeon, who appreciates the Sergas effort to incorporate robotics into the seven major hospitals in Galicia. In the case of Chuac, where the Da Vinci is the one with the highest performance in Galicia, they have chosen to focus their application on those cases that can benefit the most from its advantages, the most complex.