Pancreatic cancer is a very aggressive disease that is prone to metastasizing or spreading. Unfortunately, it has been rising in incidence in the United States with approximately 50,000 new cases per year. Treatment for pancreatic cancer varies depending on the individual patient, but when determining surgical treatment options we consider these questions: Has the tumor spread? Is it removable? And is the patient in good enough shape to have surgery?
If surgery is an option, the approach for pancreatic cancer is dictated by where the tumor is located, and the surgeon may remove parts or, in rare circumstances, the entire pancreas. Most tumors are diagnosed in the head of the pancreas, and these can be removed with a pancreaticoduodenectomy, also known as the Whipple procedure. The Whipple procedure, an aggressive operation that typically takes between three to six hours to complete, involves removing a third of the pancreas and part of the intestines called the duodenum. However, if the tumor is on the other side of the pancreas then it can be removed with something called a distal pancreatectomy, which involves less reconstruction than the Whipple procedure.
In addition to the standard surgical options, we also utilize technologically advanced, minimally invasive surgical approaches using laparoscopy and robotic surgery. Laparoscopic surgery involves placing medical instruments in the belly through tubes, which results in smaller incisions. This approach can get patients out of the hospital a little faster because of less blood loss and fewer complications than standard surgery. We are also using cutting-edge robotic surgery for pancreatic cancer. This technology can be used in the Whipple procedure and the distal pancreatectomy, and the robot provides the surgeon with incredible dexterity. While traditional laparoscopic instruments do rotate and open and close, the robot has wrists and 3D visualization. This allows the surgeon to see things with good depth perception instead of looking at a flat screen, which can be especially helpful for complex surgeries in confined areas. The surgical robot is a valuable, minimally invasive tool for selective circumstances, although it is not necessary for all pancreatic procedures.
About Dr. Kooby
David A. Kooby, MD, FACS, is a board certified surgical oncologist specializing in laparoscopic and open surgical treatment of pancreas, bile ducts, stomach, and colon cancers. Dr. Kooby is a pioneer in minimally invasive and robotic pancreatic surgery, and serves as Professor of Surgical Oncology in the Department of Surgery at Emory University School of Medicine. Dr. Kooby also is the Director of Surgical Oncology at Winship at Emory Saint Joseph’s Hospital and the Director of Minimally Invasive GI Surgical Oncology at Emory University School of Medicine. Dr. Kooby will be co-directing the International Hepato-Pancreato-Biliary Association State of the Art Conference
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