A first at Providence St. Joseph Hospital: Robotic-assisted Whipple surgery performed

In April, the first robotic-assisted Whipple Surgery (Pancreatoduodenectomy) at Providence St. Joseph Hospital was performed by Hisham El-Bayar, MD, Director of the Liver, Bile Duct and Pancreas Program at The Center for Cancer Prevention & Treatment. More patients are scheduled.

The patient, in her 60s, had a periampullary tumor with stage II pathology. Her minimally invasive procedure took just under five hours, and she is doing well, according to Dr. El- Bayar, who estimates she has a 60% chance for extended (5 year) disease-free survival.

Pancreatic cancer affects 60,000 people in the US. About 20% of patients are eligible for the Whipple procedure–typically patients whose tumors are located at the pancreas’ head and haven’t metastasized beyond the pancreas.

“It takes our entire team to take care of these patients,” he says. “Our multidisciplinary hepatobiliary program includes gastroenterologists, interventional radiologists, oncologists, radiation oncologists, an NP nurse navigator, and support services such as nutrition, rehab, etc.

“With time, I believe more cases currently considered resectable due to tumor location will be done with robotic assistance, in part because of the greatly improved visualization,” says Dr. El-Bayar. “Surgical outcomes are not much different using the robot, but it’s a much easier post-op period for the patient because of the small incisions, less pain and early mobilization – that’s the benefit.”

A robotic surgeon of about 10 years, Dr. El- Bayar was well-prepared to perform the robotic- assisted procedure due to a long experience with the open operation and thanks to encouragement from Intuitive and the Providence Mission Hospital team headed by Dr. Ahmad Abou Abbass.

Dr. El-Bayar adds, “It’s the same operation as a traditional Whipple operation, so it was a matter of having the confidence to use the robot, and being conservative in waiting to see if outcomes compare favorably to open operations.”

“Robotic-assisted minimally invasive Whipple surgery is a major milestone for cancer care at St. Joseph’s,” says Medical Director of Robotic Surgery, Abtin H. Khosravi, MD. “It is one of the most complicated operations a surgeon can do, and very few in our area perform it. This is a great accomplishment for Dr. El-Bayar, our robotics program, and for patients.”