Sunway city: Advances in robotic-assisted surgery are transforming the treatment of pancreatic diseases, offering patients greater precision, fewer complications, and faster recovery. Hepatobiliary and Pancreatic Surgery, and Robotic Surgery Specialist at Sunway Medical Centre, Sunway City (SMC), Dr Bong Jan Jin, indicated that pancreatic surgery, once associated with large incisions and prolonged hospital stays, has evolved significantly with the adoption of minimally invasive and robotic techniques.
According to BERNAMA News Agency, Dr. Bong explained that pancreatic surgery involves removing part of the pancreas, a deeply situated organ behind the stomach. Given its position and proximity to major blood vessels, the surgery is highly complex and requires specialized skill. Surgery is commonly indicated for malignant and benign tumors, chronic inflammation such as pancreatitis, and traumatic injuries to the pancreas.
Among the common procedures is distal pancreatectomy, which involves removal of the body and tail of the pancreas. Dr. Bong noted that in certain cases, the spleen may also need to be removed, although surgeons aim to preserve it whenever possible due to its role in immune function. The spleen controls the immune function of the body, playing a key role in defending against bacterial threats. Without it, patients are exposed to certain risks of infection.
Traditional open surgery requires a large abdominal incision, which may result in significant postoperative pain, a higher risk of wound infection, and a longer recovery time. The latest development in this field is the transition to robotic surgery. Surgeons now operate through small incisions using robotic arms controlled from a console. The system provides a magnified three-dimensional view of the internal organs, with the robotic arms offering a high degree of movement, mimicking the natural human wrist, allowing better precision in tight spaces.
Dr. Bong emphasized that patients undergoing robotic pancreatic surgery generally experience less pain, reduced reliance on strong painkillers, and quicker return of bowel function compared to conventional surgery. Robotic surgery typically allows for faster recovery, enabling patients to be mobile sooner. If no complications arise, patients may be discharged within seven to ten days and resume daily activities sooner.
Regarding patient eligibility, Dr. Bong stated that suitability for robotic or laparoscopic surgery depends on the tumor's location, size, and whether major blood vessels are involved. He also highlighted the increasing practice of administering chemotherapy before surgery for selected pancreatic cancer patients. Neoadjuvant chemotherapy can help shrink the tumor and increase the likelihood of complete removal, improving long-term outcomes in appropriate cases.
Addressing common patient concerns, Dr. Bong mentioned worries about developing diabetes post-surgery. In cases of distal pancreatectomy, it depends on whether the patient is pre-diabetic, diabetic, or has no history of diabetes. For non-diabetic individuals, it is unlikely they will become diabetic post-surgery, as the remaining pancreas can typically compensate for insulin and enzyme secretion.
Dr. Bong advised postoperative patients to adopt small, frequent meals with a high-protein, low-fat, and less sugar diet to support recovery. This dietary approach allows the body to adjust to the new norm, compensating for the loss of 50% of the pancreas. With dietary advice and guidance, successful adjustment is usually achievable.
In the long run, most patients recover fully after robotic surgery, with only four tiny abdominal incisions as visible signs, Dr. Bong concluded.