Robotic pancreaticoduodenectomy after Roux-en-Y gastric bypass

Morbid obesity is a growing problem worldwide and a known risk
factor for development of pancreatic cancer. The Roux-en-Y gastric
bypass (RYGB) has proven to be a highly effective operation against
obesity and its associated comorbid conditions and has a favorable
metabolic side effect profile when compared with the more radical biliopancreatic
diversion with duodenal switch. Numerous high-quality
studies have demonstrated the efficacy and safety of the procedure. It
has since become and remains the gold standard operation in the battle
against the obesity epidemic. Although the risk of developing
pancreas cancer after a gastric bypass is low, with the increased
number of gastric bypass procedures being performed, it is anticipated
that the number of patients with gastric bypass requiring a pancreaticoduodenectomy
will certainly increase. In the event of a periampullary
tumor or pancreatic head lesion requiring resection of the
head of the pancreas, the operation poses an additional challenge that is
the reconstruction of the alimentary tract due to the altered anatomy.
This video shows a robotic pancreaticoduodenectomy in a patient with
prior laparoscopic Roux-en-Y gastric bypass.
Supplementary video related to this article