Although the survival rate for pancreatic cancer is low, surgery can often be a cure if the disease is caught and treated before it has spread to other parts of the body.
When people think of surgery, they often imagine large incisions and long, painful recoveries.
Minimally invasive surgery, however, uses smaller incisions to perform many of the same procedures that can be performed through traditional “open” surgery.
Dr. Dominic Sanford, chief of the Section of HPB-GI surgery at WashU Medicine and director of hepatobiliary and pancreatic surgery at Missouri Baptist Medical Center, shares some helpful things to know about minimally invasive pancreatic cancer.
What is minimally invasive surgery?
There are a few main types of minimally invasive technology used in surgery. For pancreatic cancer, the two main types of minimally invasive approaches are:
- Laparoscopic surgery: This type of surgery involves the use of surgical tools, a light, and a camera, which are all placed inside the body through small incisions. The surgeon is at the bedside in the operating room, using the surgical tools, while other members of the surgical team control the light and camera.
- Robotic surgery: During robotic surgery, the surgeon sits at a console in the operating room. From their console, the surgeon controls the arms of a robot to perform an operation through small incisions. The light and camera used for robotic surgery are all controlled by the surgeon at their console.
Here are a few useful things to know about minimally invasive surgery and its use in treating pancreatic cancer.
1. The technology has been in use for decades
Laparoscopic surgical technology has been around since the early 20th century.
Some of the earliest uses for laparoscopic surgery were in obstetrics and gynecology, where doctors performed laparoscopic tubal ligation (also called sterilization or “getting your tubes tied”).
The first laparoscopic Whipple procedure for pancreatic cancer was described in 1994 by Dr. Michel Gagner in the journal Surgical Endoscopy. At the time, Dr. Gagner wrote that, though “technically feasible, the laparoscopic Whipple procedure may not improve the postoperative outcome or shorten the postoperative recovery period.”
In the years since Dr. Gagner first performed a laparoscopic pancreatectomy, the tools used for minimally invasive surgery have improved, as have the surgical techniques.
With more recent advances in technology and techniques, laparoscopic surgery is commonly used to remove multiple forms of cancer, including pancreatic cancer.
“In fact, minimally invasive approaches have been found to have many benefits for patients,” Dr. Sanford says.
2. Robotically assisted surgery provides additional benefits
In general, minimally invasive surgery often has benefits over “open” surgery when the patient is a good candidate for a minimally invasive approach.
Robotic surgery in particular can provide several benefits, including:
- Enhanced visualization: The camera used in robotic surgery provides a 3D image, which allows the surgeon to see in great detail throughout the procedure.
- Wristed motion: A surgical robot has “wrists” that can move with flexibility. This lets the surgeon easily manipulate the tools needed to perform an operation.
- Improved outcomes: Compared to traditional open surgery, minimally invasive procedures have been found to result in potentially better outcomes for some patients. These outcomes can include less blood loss, less pain, quicker return to gastric function, quicker recovery times, fewer complications, and shorter hospital stays.
3. Experience matters when it comes to minimally invasive surgery
While minimally invasive technology can have several benefits for surgery, it’s important to be sure that your surgeon has the experience to effectively perform complex surgery using this technology.
“Pancreatic surgeons at WashU Medicine see a high volume of patients with pancreatic cancer,” Dr. Sanford says. “People come to St. Louis to see us because of our expertise. Approximately 70-80% of pancreatic cancer surgeries performed by our team are done with a minimally invasive approach, including robotic surgery.”
A 2021 study published in the journal Surgical Endoscopy and led by researchers at WashU Medicine compared the outcomes of minimally invasive versus open Whipple procedures. The study found that, overall, patients who had minimally invasive procedures had significantly less blood loss and lower complication and 90-day readmission rates and were more likely to have an ideal outcome than those who had open surgery.
“In our hands, patients go home about 3.5 days sooner after a robotic Whipple procedure,” Dr. Sanford says.
Dr. Sanford notes that the outcomes reported in this study were only for surgeries performed by WashU Medicine physicians, meaning that they may not reflect results at a national level.
4. Find a cancer care team you can trust
Which type of surgery is best depends on the individual and their condition. Minimally invasive pancreatic surgery can be beneficial for many people with pancreatic cancer, but there are times when an open approach might still be best.
Finding an expert pancreatic cancer care team that you can trust is key. Your team of health care professionals will help you find the treatment that best suits your specific situation.
To make an appointment or refer a patient to a WashU Medicine pancreatic surgeon, please call 314-362-2280.
Learn more: Pancreatic cancer