• KIMS Hyderabad is the first hospital in AP and Telangana to do 100 robotic Whipple surgeries
• The surgeries were performed by using advanced da Vinci robotic system

Krishna Institute of Medical Sciences (KIMS), a leading multi-specialty hospital in Hyderabad, became the first private hospital in India to successfully complete 100 robotic-assisted Whipple surgeries to treat complicated pancreatic cancers. The Whipple procedure, also known as a pancreaticoduodenectomy, is a surgical operation to treat complex tumors in the pancreas and adjoining regions that are challenging to access and remove due to their location and involvement with critical blood vessels and organs.

The majority of the 100 cases involved patients aged 14 to 80, primarily from Hyderabad and other district headquarters such as Karimnagar, Nizamabad, and nearby regions. They all suffered from malignant pancreatic tumors, which were bulky and ranged from 4 cm to 8 cm in size.

Dr. Madhu Devarasetty, Senior Consultant Surgical Oncologist at KIMS Hyderabad, who led the team of experts that achieved the milestone, said, “Even in the rarest and most complicated of pancreatic cancer cases, we decided to employ robotic technology for the surgery to avoid major complications, and to enable quicker recovery times. Most of the patients were discharged on the fifth day after surgery, and could go back to living their normal lives soon.”

Reconstruction is a critical step in the procedure, as it directly impacts the duration of the patient’s recovery and discharge. If the pancreaticojejunostomy is not sutured and reconstructed properly, it can lead to leaks, resulting in infections, sepsis, fever, and deranged vital signs. By using the advanced robotic system, da Vinci, pancreaticojejunostomy reconstruction was done with ease and without many complications.

The team at KIMS devised and standardized techniques at every step of the procedure i.e. –  from resection to reconstruction, and even in the  use of suture materials also so that optimal patient outcomes could be achieved.
They recently performed a robotic-assisted total Whipple procedure on a 58-year-old woman who presented with anemia and blood in her stool. Upon evaluation, they identified a 6×6 cm tumor in the head of the pancreas extending into the duodenal wall. Performing a total robotic Whipple for such a large tumor posed significant challenges, but the surgery proceeded smoothly. The surgical connections between tissue structures were highly satisfactory, and the patient was discharged on the fifth postoperative day.

Similarly, Dr. Madhu cites another case, one that was performed a few years ago. An 18-year-old girl presented with an 8-centimeter tumor in the head of the pancreas, causing abdominal pain. She underwent a robotic-assisted total Whipple procedure, despite the tumor compressing the superior mesenteric vessels. The surgery was successfully performed, and the patient was discharged on the fifth postoperative day. She even went on to get married, and has two children now.

These two cases highlight the efficacy of the robotic-assisted total Whipple procedure in managing large pancreatic lesions and large pancreatic tumors, both the patients were very pleased with the outcomes, and are doing very well,” he added.

According to Dr. Madhu, robotic-assisted surgery is what made all the difference. “Advanced robotic technology, da Vinci has improved the reconstruction process, offering precise placement of sutures through advanced magnification. The dexterity of the robotic needle holder allows for swift and accurate suturing, similar to fine artwork. This precision has significantly improved surgical outcomes, said Dr. Madhu, adding, “With other modes of surgery, the challenge was that during reconstruction, the movements didn’t quite match the precision of the robotic system. The placement of sutures wasn’t as accurate. But when I transitioned to robotic-assisted surgery, the difference was immediate. From the very first case, we completed the entire Whipple procedure robotically without needing to convert to open surgery.”

Dr. Madhu is of the opinion that there is a rise in pancreatic cancer cases in the region, and there is a pressing need to spread awareness about the symptoms and the importance of early detection. “If you notice symptoms such as persistent jaundice and fever, it is advisable to get yourself evaluated by a medical professional at the earliest. Early detection can go a long way in improving treatment outcomes and increasing survival rates,” he advised.