There are various diseases of the pancreas that can be treated well with minimally invasive surgery. These include, for example, chronic inflammatory processes (pancreatitis) or tumors.
Here you will find further information as well as selected specialists and centers for minimally invasive pancreatic surgery.
Minimally invasive means that the access routes to the inside of the body are kept as small as possible (=minimal) in order to cause the patient as little strain as possible.
In the open method of surgery, the surgical field is accessed via a skin incision. The length of the incision varies depending on the extent of the procedure. The advantages lie in the good control of the surgical field through direct manual access. The disadvantages are a significantly longer recovery time and the risk of complications from scars and wounds.
Before the introduction of minimally invasive methods, all operations were performed with large incisions, which were sometimes very stressful for the patient, were associated with a long hospital stay and often led to wound healing problems. Minimally invasive procedures have been increasingly available since 1986. Ultimately, these procedures are now used in almost all areas of surgery, urology, gynecology, etc.
The minimally invasive approach is made possible via skin incisions just a few millimetres in size. Tiny instruments attached to rods are inserted into the body through these incisions. These include a small camera that transmits images from the surgical field to a monitor.
The terms keyhole or buttonhole surgery have also become established for minimally invasive surgery. If the operation takes place in the abdominal cavity, it is referred to as laparoscopy.
Surgery is often necessary for benign and especially malignant diseases of the pancreas. This so-called pancreatic surgery is a form of visceral surgery (abdominal surgery).
Pancreatic surgery is necessary in cases of chronic pancreatitis (inflammation of the pancreas), which is a benign disease. Approximately every second patient benefits from the surgical procedure and generally has a significantly improved quality of life afterwards.
This is due to the fact that inflammation of the pancreas is very often accompanied by considerable pain. This cannot always be adequately controlled with medication. In this case, laparoscopy is often the treatment of choice. Among other things, inflamed areas of the pancreas are removed or fluid-filled cavities (cysts) are opened.
One of the most common reasons for surgical treatment of the pancreas is pancreatic cancer (pancreatic carcinoma). The focus here is on tumor removal.
The type and choice of surgical procedure (open surgery or minimally invasive) depends on the exact location of the tumor and whether it has spread to adjacent tissue. If the disease is limited to the pancreas and is still relatively small, the keyhole technique will be suggested and performed (whenever possible).
The location of the pancreas © nerthuz | AdobeStock
The specific visceral surgery procedure that is suitable for the operation depends primarily on the exact nature of your condition. The existing changes to the pancreas play a major role here.
Your attending physician will inform you in detail about the procedure that is best suited to your findings.
A resection is the surgical removal of a part of the body. In a left pancreatic resection, for example, the left area of the pancreas is removed. This area is called the pancreatic tail because it extends to the left towards the spleen like a tail. In the case of malignant tumors, however, a sufficient safety margin must always be ensured.
For this reason, it may sometimes be necessary to remove the spleen when the tail of the pancreas is affected. People can live well without a spleen, but are susceptible to some infectious diseases. If possible, the spleen should be retained; in the case of benign tumors, this is almost always possible.
This procedure, which is generally minimally invasive, also focuses on preserving the pancreas and its functions.
Only a small part (segment) of the pancreas is removed. Most of the rest remains intact. This procedure is primarily performed on benign tumors. These are often located in the center, i.e. in the body (corpus), of the pancreas.
In pancreatic left resection and pancreatic segment resection, the function of the pancreas is preserved and is sufficient for life, even if the operation has reduced the overall size of the pancreas. Hormones and digestive enzymes are produced in sufficient quantities and enter the intestine and bloodstream naturally. Consequently, the replacement of hormones and digestive enzymes with medication is not necessary in the case of partial pancreatectomies.
In this procedure, the pancreas is completely removed, often together with the spleen. This operation is often necessary for malignant tumors to ensure that all malignant tumor tissue is removed. After a pancreatectomy, it is necessary to inject insulin and take digestive enzymes in capsule form for the rest of the patient's life.
This procedure is considered particularly demanding and is only performed by specialists in dedicated centers. The surgeons Allen Whipple (USA) and Walther Kausch (Germany) were instrumental in shaping this procedure and thus gave it their names.
The operation is usually performed on the head of the pancreas in the case of aggressive cancer. This is located very close to the duodenum (duodenum) and the bile duct.
Parts of the pancreas are removed
It is also possible to remove the duodenum and bile duct as well as the lymph nodes. However, this is becoming less and less necessary thanks to gentler methods.
In principle, the extent of tumor removal from the head of the pancreas also depends on the spread of the tumor. The earlier the diagnosis is made, the less tissue is removed by the surgeon.
Like all abdominal operations, pancreatic surgery also carries a certain risk of complications. These include, for example
Infections in the area of the former pancreatic lumen (this is the medical term for the space in which the pancreas was located before removal) are also not uncommon. Even if the skin incisions are very small in minimally invasive procedures, they can become infected and make a second operation necessary. For this reason, antibiotics are often administered during and after the operation.
However, as pancreatic surgery is a very complicated surgical procedure, surgical treatment of the pancreas is usually carried out in specialized centers. This also demonstrably reduces the risk of complications.
The prognosis (prediction of recovery) for the course of the disease after minimally invasive pancreatic surgery depends on various factors. These include the initial severity and general findings of your disease.
In the case of pancreatic cancer, supportive chemotherapy lasting several months is often offered. The aim of this is to eliminate any remaining tumor cells. Supplementary radiotherapy (radiation) is also possible.
Careful tumor aftercare for the early detection of secondary diseases is a matter of course.
In the case of malignant tumors, the stage of the disease is the main indicator of successful healing. Tumors that are localized can usually be treated well. Unfortunately, the diagnosis is often only made at a very advanced stage of the disease. A cure is then often no longer possible. The focus is now on prolonging life and improving quality of life.
The prognosis for benign tumors and original foci of inflammation in the pancreas is generally very good. In most cases, a complete cure can be expected.
Minimally invasive pancreatic surgery treats benign and malignant diseases of the pancreas. Experts in these procedures are surgeons who focus on general and visceral surgery and specialize in pancreatic surgery.
Early diagnosis is important for a successful operation.
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