Innovation at UPMC: New Hope for Pancreatic Cancer Patients

Robotic technology revolutionizing Whipple surgery

When Coy Smith* found out he had pancreatic cancer and needed a Whipple procedure, he started getting his affairs in order. He even considered going without surgery. “It occurred to me that I might not come back home,” says Mr. Smith.

Although he left most of the worrying up to his wife, a licensed practical nurse, he knew enough to realize the surgery would not be a simple task. Whipple surgery — one of the most complex surgeries performed — involves the removal of the head of the pancreas, gallbladder, bile duct, part of the stomach, and small intestine.

But the 58-year-old Altoona-area resident was lucky. He was one of the first patients at UPMC Cancer Centers to undergo a non-invasive version of the Whipple procedure using state-of-the-art robotic technology. He was operated on in October 2009 by the surgical team of A. James Moser, MD, and Herbert J. Zeh, MD — co-directors of the Pancreatic Specialty Care Center and two of just a handful of surgeons worldwide who perform the Whipple procedure using robotic surgical technology.

Mr. Smith woke up in recovery and immediately began joking with the nurses. After a week’s stay in the hospital, Mr. Smith began six months of chemotherapy. One year later, he is cancer-free. “I’m healthy and very fortunate,” Mr. Smith says.

 “This is pioneering technology — the first major innovation in pancreas surgery in more than 100 years — and UPMC is considered among the world’s leaders,” says Dr. Moser.

Doctors performing Whipple surgery.Precise robotic technology

Surgeons use the da Vinci® Si Surgical System, a robotic surgical device that allows them to operate through a series of small incisions (including one to accommodate a miniature camera) with greater dexterity and range of motion, plus a magnified threedimensional view of organs on a large, high-definition screen. Instead of the “chopsticks” used in laparoscopy, robotic surgery equipment allows for more natural movements, including wrist function, explains Dr. Zeh.

“It has a 360-degree range of motion, which has much more freedom of movement than your own hand,” says Dr. Zeh. “You can get into places where your hand can’t go.”

The robotic technology enhances the surgeon’s ability to see detail and manipulate anatomical parts with great precision. Like conventional laparoscopic surgery, robotic surgery is minimally invasive.

Patients benefit

The two surgeons have published papers on the robotic Whipple procedure and have spoken at conferences around the world. They are now compiling data on patient outcomes.

While it is not yet clear whether this approach produces better surgical outcomes, both surgeons say it is clear that patients may benefit in many ways, including less pain, reduced recovery time, minimal scarring, and reduced need for blood transfusions. That means patients can begin chemotherapy sooner.

“We are pleased to be able to offer this new technology,” Dr. Zeh says. “The data shows that as a whole, patients who undergo the robotic-assisted Whipple procedure do as well as patients who have the traditional open surgery.”

Perhaps the biggest benefit is reducing fear in patients. According to Dr. Moser, as many as one half of all pancreatic cancer patients choose not to have surgery to remove their tumor because they are afraid of a large incision and the long recovery time associated with traditional surgery.

“We hope that by minimizing the trauma of surgery we can get more people to select this treatment and continue on with chemotherapy,” Dr. Moser says. “Not everyone with pancreatic cancer is doomed. This procedure is giving patients hope.”

* Mr. Smith’s treatment and results may not be representative of similar cases.

For more information about the robotic Whipple procedure or any of UPMC's pancreatic cancer treatments, call 1-888-623-PANC (7262).

Potential Benefits of the Robotic Whipple Procedure

  • Smaller incisions
  • Minimal scarring
  • Reduced blood loss and need for transfusion
  • Less pain
  • Shorter hospital stays
  • Faster recovery time and start of treatment

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