Inframesocolic Approach for Robotic Enucleation of Branch-Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas

BackgroundThe inframesocolic approach to the uncinate process of the pancreas has been rarely described in literature. To the best of our knowledge, no robotic cases have been reported.MethodsThe case of a 74-year-old woman, with a 43-mm branch-duct intraductal papillary mucinous neoplasm with worrisome features within the uncinate process of the pancreas, is described.ResultsAfter diagnostic work-up, due to the uncertain potential of malignancy and the strong motivation of the patient to undergo surgery, we performed a robotic enucleation through an inframesocolic approach. The neoplasm was more than 1 cm from the main pancreatic duct. Final pathological diagnosis revealed a low-grade dysplasia branch-duct intraductal papillary mucinous neoplasm.ConclusionsThe inframesocolic approach could represent an easy way to access the uncinate process of the pancreas, allowing safe limited resection in selected cases such as small branch-duct IPMN or pancreatic neuroendocrine tumors.

Automated summary

This article describes a case of a 74-year-old woman with a branch-duct intraductal papillary mucinous neoplasm located more than 1 cm from the main pancreatic duct. A robotic enucleation through an inframesocolic approach was performed successfully. The final pathological diagnosis revealed a low-grade dysplasia branch-duct intraductal papillary mucinous neoplasm. The inframesocolic approach can provide a safe limited resection for selected cases.