Surgery Today

, Volume 48, Issue 7, pp 680–686 | Cite as

Application of a commercial single-port device for robotic single-incision distal pancreatectomy: initial experience

  • Cheng-Ming Peng
  • Hsin-Cheng Liu
  • Ching-Lung Hsieh
  • Yao-Kun Yang
  • Teng-Chieh Cheng
  • Ruey-Hwang ChouEmail author
  • Yi-Jui LiuEmail author
Original Article



Laparoscopic distal pancreatectomy has proven to be feasible and safe. Moreover, robotic surgery provides unique advantages for pancreatic procedures, although single-incision robotic pancreatic surgery is rarely discussed. We applied the single-port modified platform to accomplish robotic distal pancreatectomy in a series of patients.


The subjects of this study were ten patients who underwent robotic distal pancreatectomy in our hospital between July 1, 2015 and Dec 31, 2016. All patients were placed supine in the reverse Trendelenburg position with the legs abducted. Surgery was performed via a trans-umbilical 5.0-cm incision, using a modified single-port platform (LAGIPORT®) combined with the da Vinci Si Surgical System. The three arms and scope (30-degree up) were inserted through the LAGIPORT® and positioned in a triangle. Endoscopic ultrasound was used to localize the tumor and plan the resection margin. We recorded the surgical time, operation time, blood loss, postoperative pain score, hospital stay, and complications.


The surgical time was 236 ± 32 min, the operation time was 172 ± 30 min, and the blood loss was 149 ± 65 ml. All patients underwent robot-assisted distal pancreatectomy without conversion. The average pain score on postoperative day (POD) 3 was 4.5 ± 1. Complications included subsplenic hematoma (n = 1) and minor pancreatic leakage (n = 2). There was no surgical mortality.


Our results demonstrate the safety and efficiency of robotic single-incision distal pancreatectomy via the modified platform (LAGIPORT®).


Distal pancreatectomy Robotic surgery Single-incision surgery 



This study was supported by the grants, FCU/CSMU104-001 from Feng Chia University/Chung Shan Medical University and MOST 105-2320-B-039-059-MY3 from the Ministry of Science and Technology.

Compliance with ethical standards

Conflict of interest

We have no conflicts of interest to declare.

Supplementary material

Supplementary material 1 (MPG 52226 KB)


  1. 1.
    Daouadi M, Zureikat AH, Zenati MS, Choudry H, Tsung A, Bartlett DL, et al. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg. 2013;257(1):128–32. CrossRefPubMedGoogle Scholar
  2. 2.
    Zureikat AH, Moser AJ, Boone BA, Bartlett DL, Zenati M, Zeh HJ. 3rd. 250 robotic pancreatic resections: safety and feasibility. Ann Surg. 2013;258(4):554–9. (discussion 9-62)PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, et al. Transumbilical single-port surgery: evolution and current status. Eur Urol. 2008;54(5):1020–9. Scholar
  4. 4.
    Antoniou SA, Pointner R, Granderath FA. Single-incision laparoscopic cholecystectomy: a systematic review. Surg Endosc. 2011;25(2):367–77.
  5. 5.
    Machado MA, Surjan RC, Makdissi FF. First single-port laparoscopic pancreatectomy in Brazil. Arq Gastroenterol. 2013;50(4):310–2. Scholar
  6. 6.
    Takahashi T, Takeuchi H, Kawakubo H, Saikawa Y, Wada N, Kitagawa Y. Single-incision laparoscopic surgery for partial gastrectomy in patients with a gastric submucosal tumor. Am Surg. 2012;78(4):447–50.PubMedGoogle Scholar
  7. 7.
    Machado MA, Makdissi FF, Surjan RC. Single-port for laparoscopic gastric resection with a novel platform. Arq Bras Cir Dig. 2014;27(2):157–159.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Morel P, Pugin F, Bucher P, Buchs NC, Hagen ME. Robotic single-incision laparoscopic cholecystectomy. J Robot Surg. 2012;6(3):273–4. Scholar
  9. 9.
    Kim SH, Kang CM, Lee WJ. Robotic single-site plus ONE port distal pancreatectomy. Surg Endosc. 2017;31(10):4258–9. Scholar
  10. 10.
    Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13. Scholar
  11. 11.
    Joyce D, Morris-Stiff G, Falk GA, El-Hayek K, Chalikonda S, Walsh RM. Robotic surgery of the pancreas. World J Gastroenterol. 2014;20(40):14726–32. Scholar
  12. 12.
    Hashimoto M, Watanabe G, Matsuda M, Mori M. Serous cystic neoplasm of the pancreas-indications for surgery. Hepatogastroenterology. 2006;53(72):950–2.PubMedGoogle Scholar
  13. 13.
    Far SS, Miraj S. Single-incision laparoscopy surgery: a systematic review. Electron Physician. 2016;8(10):3088–95. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Podda M, Saba A, Porru F, Pisanu A. Systematic review with meta-analysis of studies comparing single-incision laparoscopic colectomy and multiport laparoscopic colectomy. Surg Endosc. 2016;30(11):4697 – 720. Scholar
  15. 15.
    Escobar PF, Haber GP, Kaouk J, Kroh M, Chalikonda S, Falcone T. Single-port surgery: laboratory experience with the da Vinci single-site platform. JSLS. 2011;15(2):136–41. Scholar
  16. 16.
    Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, et al. Distal pancreatectomy: is staple closure beneficial? ANZ J Surg. 2003;73(11):922–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Cheng-Ming Peng
    • 1
    • 2
  • Hsin-Cheng Liu
    • 2
  • Ching-Lung Hsieh
    • 2
  • Yao-Kun Yang
    • 2
  • Teng-Chieh Cheng
    • 3
  • Ruey-Hwang Chou
    • 4
    • 5
    Email author
  • Yi-Jui Liu
    • 1
    • 3
    Email author
  1. 1.Program of Electrical and Communications EngineeringFeng Chia UniversitySeatwenTaiwan
  2. 2.Da Vinci Minimally Invasive Surgery CenterChung Shan Medical University HospitalTaichungTaiwan
  3. 3.Department of Automatic Control EngineeringFeng Chia UniversitySeatwenTaiwan
  4. 4.Graduate Institute of Biomedical Sciences and Center for Molecular MedicineChina Medical UniversityTaichungTaiwan
  5. 5.Department of BiotechnologyAsia UniversityWufengTaiwan

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