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ROBOTIC PANCREATIC CANCER PROCEDURE
Astonishing recovery rates with the use of robots in pancreatic cancer treatment by Houston surgeon, Dr. S. Manny Ayyar The Whipple procedure, which has historically been thought of as one to the most complex surgical procedures of the abdomen, can now be considered minimally invasive. On Thursday, February 19, 2015, a surgical team led by Dr. S. Manny Ayyar and his partner, Dr. Jorge Leiva, performed one of the first robotic Whipple procedures in Houston, Texas. The Whipple operation, also called a pancreaticoduodenectomy, is the most common surgical treatment for cancerous or benign tumors of the head of the pancreas, duodenum, ampulla of Vater or the common bile duct. It involves removal of the head of the pancreas, bile duct, duodenum, part of the stomach, and the gallbladder. North Cypress Medical Center in Cypress, Texas is among an elite group of hospitals across the United States offering the state-of-the-art fully robotic Whipple surgery. Pancreatic cancer is the fourth leading cause of cancer deaths. In 2015, the American Cancer Society estimates 49,000 people are expected to be diagnosed with pancreatic cancer in the United States. For those patients who are candidates for surgical resection, the Whipple procedure is potentially life-saving. Pancreatic cancer and its associated treatments are traditonally very debilitating for the patient. Now, with the combination of Dr. Ayyar’s advanced laproscopic skills and the da Vinci robot by Intuitive Surgical, we are able to recapture the quality of life for these patients. The fully robotic Whipple surgery requires a highly technical skill set that only the most advanced surgeons can carry out with success. The robotic approach enhances the operation with its three-dimensional portrayal of the abdominal cavity and surgical field, assisting the surgeon in making precise dissections and reconstructions. Since the operation employs minimally invasive techniques, patients have less pain, minimal blood loss, and without large scars. The robotic Whipple also allows patients who have cancer to start chemotherapy and radiation therapy sooner, which is vital in the potential cure of this disease. In his first fully robotic assisted Whipple, Dr. Ayyar treated a 65 year old diabetic patient who had lost her brother 18 months ago to pancreatic cancer. After a comprehensive evaluation, she was deemed appropriate for surgical excision. During this Whipple operation, Drs. Ayyar and Leiva guided the robotic system to make a few small incisions to accommodate both the laparoscope and robotic arms. In this method, they were able to precisely control the movements of the surgical instruments to resect and reconstruct the bile duct, pancreas, and stomach. With the magnification and 3D visualization that the da Vinci robot allowed, Dr. Ayyar was able to use hair like sutures to connect ducts as small as the lead of a pencil to the small intestine. She recovered rapidly with a postoperative course that was uncomplicated. Traditionally, the length of hospital stay for this surgery would be bewteeen 7-14 days. In this case, the patient was discharged home only 3 days after the robotic Whipple. She was seen as an outpatient on post-operative day 6 to schedule the remainder of her treatment. Robotic surgery is an innovative technology that is beneficial for certain abdominal operations and diseases. It provides minimally invasive approaches to very complex procedures which results in a quicker return to normal activities and improved patient satisfaction. Dr. Subramanyam Manny Ayyar and his group at North Houston Surgical Associates (NHSA), including Drs. Jorge Leiva and Ziad Amr are changing the paradigm of how people experience healthcare. Dr. Ayyar has been a practicing surgeon in the Houston area since 1999. He is in the forefront of minimally-invasive surgery and now advancing medicine through technology in the form of robotic-assisted surgery. “The robotic Whipple procedure should be the primary method of performing this surgery barring any extenuating circumstances.” Dr. Ayyar “The optics of the robot, including high definition, 10 times magnification and the three dimensional views offer a great advantage for accomplishing complex surgeries such as the pancreaticoduodenectomy.” Dr. Leiva “This (robotic Whipple) procedure was the smoothest Whipple I’ve ever been involved with.” Dr. Vishal Raizada with Greater Houston Anesthesia If you would like to learn more about robotic pancreas surgery and other minimally-invasive procedures, please call (713) 426-2400 or visit www.houstonsurgeons.net
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