Background : Splenic vessel preserving distal pancreatectomy is difficult operation because of manipultaing small blood vessel without injury of splenic artery and vein. There is a report that robotic single site plus one port distal pancreatectomy is feasible and safe, but only a few cases were performed with vessel preservation. Recently, we experienced first case of robotic single site plus one port splenic vessel preserving distal pancreatectomy.

Methods : This operation was first case of robotic distal pancreatectomy in our institution. A 56 years-old male was diagnosed with neuroendocrine tumor. The preoperative image studies revealed a 1.7 cm sized avid enhancing mass with focal calcification at far tail of pancreas. The patient was scheduled to undergo single site plus one port robotic distal pancreatectomy (Davinci-Xi).

Results : Robotic single site plat form was used through umbilical incision and additional 12mm port was used at left side of umbilicus. Robotic camera, one robotic single site arm and assistant’s instrument was used through umbilical port, and the other robotic endo-wrist function instrument was used through additional 12mm port. The total operation time was 135 minutes and the estimated blood loss was 10 mL without transfusion. The operation proceeded from the splenic hilum to the pancreas body with identifying and preservation of splenic artery and vein. The biopsy revealed R0 resection. The patient recovered well without complication, and was discharged on the 6th postoperative day.

Conclusions : Robotic single site plus one port splenic vessel preserving distal pancreatectomy was feasible and safe for far pancreas tail mass.