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Robotic enucleation of a pancreatic uncinate neuroendocrine tumor – a unique parenchyma-saving strategy for uncinate tumors
Ann Hepatobiliary Pancreat Surg 2020 Feb;24(1):97-103
Published online February 29, 2020;  https://doi.org/10.14701/ahbps.2020.24.1.97
Copyright © 2020 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Ken Min Chin1 and Brian K. P. Goh1,2

1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 2Duke-National University of Singapore (NUS) Medical School, Singapore
Received March 29, 2019; Revised July 28, 2019; Accepted July 28, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Pancreatic neuroendocrine tumors (PNET) comprise up to 10% of all pancreatic solid tumors. There has been much interest in recent years with regards to the role of limited resection and enucleation procedures for this entity. There is no clear guideline today on the optimal type choice of surgery for this condition, with even fewer reporting on the use of a robotic approach for pancreatic uncinate lesions. We describe a case report of a 54-year-old lady who underwent successful robotic enucleation of pancreatic uncinate neuroendocrine tumor. This patient’s recovery was complicated by pancreatitis and a peripancreatic collection, both of which resolved without surgical re-intervention. A literature review was performed with regards to current guidelines on management of PNETs, comparisons between demolitive and parenchymal-preserving procedures, and recent developments in the laparoscopic and robotic approaches for this condition. There is no clear guideline on the optimal type and approach (open vs. laparoscopic vs. robotic) to the surgical management of PNET. We document in this case report a novel approach of robotic enucleation of pancreatic uncinate process NET, that could be considered as an alternative to open/laparoscopic demolitive procedures for small uncinate tumors.
Keywords : Pancreas; Uncinate; Neuroendocrine; Robotic; Enucleation