Our Summary

Pancreatic cancer is one of the toughest cancers to treat and it takes a heavy toll on patients. Traditionally, aggressive surgery has been necessary for a chance at a cure, but this comes with many complications and can cause other health issues, like problems with blood sugar control.

Since the late 1900s, however, doctors have started to use less invasive surgical options to treat pancreatic cancer. These techniques, which include using small cameras and instruments or robots to perform the surgery, are easier on the patient and may offer the same chances of success as traditional, open surgery.

Right now, most of the evidence supporting these less invasive techniques comes from looking back at past patient outcomes. To truly compare these methods to traditional surgery, we need more forward-looking studies and trials.

In addition, doctors are increasingly treating pancreatic cancer with therapies before surgery to make the cancer easier to remove or even operable in the first place. We need to study how these less invasive techniques work in these situations.

The hope is that as we improve and standardize these less invasive techniques, and as more doctors learn how to use them, we can improve outcomes for patients with pancreatic cancer.

FAQs

  1. What is minimally invasive pancreatic resection and how does it benefit patients with pancreatic cancer?
  2. How does the outcome of minimally invasive pancreatic resection compare to traditional open surgery for pancreatic cancer?
  3. Is minimally invasive pancreatic resection feasible after neoadjuvant therapy or as conversion surgery for initially unresectable pancreatic cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about minimally invasive surgery for pancreatic cancer is that it can offer comparable oncological outcomes to open surgery with potentially better perioperative outcomes. Patients should discuss the possibility of minimally invasive pancreatic resection with their healthcare team to determine if it is a suitable option for their individual case. It is important to follow post-operative care instructions closely and attend all follow-up appointments to ensure the best possible outcome.

Suitable For

Patients who are typically recommended minimally invasive surgery for pancreatic cancer include those who are candidates for pancreaticoduodenectomy or distal pancreatectomy. These patients may have resectable or borderline-resectable pancreatic cancer, or may be undergoing conversion surgery for initially unresectable pancreatic cancer. Additionally, patients who have undergone neoadjuvant therapy and are now eligible for surgical resection may be considered for minimally invasive pancreatic resection.

Overall, minimally invasive surgery for pancreatic cancer may be recommended for patients who are fit for surgery and have tumors that are amenable to resection. It is important to note that the feasibility of minimally invasive pancreatic resection should be assessed on a case-by-case basis by a multidisciplinary team of healthcare providers.

Timeline

Before minimally invasive surgery:

  1. Patient is diagnosed with pancreatic cancer through imaging tests, biopsies, and other diagnostic procedures.
  2. Patient undergoes consultations with surgeons, oncologists, and other specialists to determine the best treatment plan.
  3. Patient may undergo neoadjuvant therapy to shrink the tumor before surgery.
  4. Patient undergoes preoperative evaluations and tests to ensure they are healthy enough for surgery.
  5. Patient is informed about the risks and benefits of minimally invasive surgery and gives consent for the procedure.

After minimally invasive surgery:

  1. Patient undergoes minimally invasive pancreatic resection (MIPR) such as pancreaticoduodenectomy or distal pancreatectomy.
  2. Patient experiences less pain, shorter hospital stays, and quicker recovery compared to traditional open surgery.
  3. Patient may require postoperative care such as pain management, monitoring for complications, and physical therapy.
  4. Patient may need additional treatments such as chemotherapy or radiation therapy to prevent cancer recurrence.
  5. Patient undergoes regular follow-up appointments with their medical team to monitor their recovery and check for any signs of cancer recurrence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about minimally invasive surgery for pancreatic cancer include:

  1. What are the potential benefits of minimally invasive pancreatic resection compared to traditional open surgery?
  2. What is your experience and expertise in performing minimally invasive pancreatic resections?
  3. What are the potential risks and complications associated with minimally invasive pancreatic resection?
  4. How long is the recovery time for minimally invasive pancreatic resection compared to open surgery?
  5. Will I still be a candidate for minimally invasive surgery if I have received neoadjuvant therapy for pancreatic cancer?
  6. What are the long-term outcomes and survival rates for patients who undergo minimally invasive pancreatic resection?
  7. Are there any specific criteria or factors that would make me a better candidate for minimally invasive surgery?
  8. What is the availability of minimally invasive pancreatic resection at the hospital or medical facility where I will be treated?
  9. Will I need any additional tests or evaluations before undergoing minimally invasive pancreatic resection?
  10. Are there any alternative treatment options for pancreatic cancer that I should consider before deciding on minimally invasive surgery?

Reference

Authors: Miyasaka Y, Ohtsuka T, Nakamura M. Journal: Surg Today. 2021 Feb;51(2):194-203. doi: 10.1007/s00595-020-02120-5. Epub 2020 Aug 28. PMID: 32857251