By Rozainah Abdul Rahim
SUBANG JAYA, July 29 (Bernama) -- 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 said pancreatic surgery, once associated with large incisions and prolonged hospital stays, has evolved significantly with the adoption of minimally invasive and robotic techniques.
“Pancreatic surgery involves removing part of the pancreas, a deep organ located behind the stomach. Because of its position and proximity to major blood vessels, it is considered highly complex and requires specialised skill,” he told Bernama in an exclusive interview recently.
Dr Bong said surgery is commonly indicated for malignant and benign tumours, chronic inflammation such as pancreatitis and accident traumatic injuries to the pancreas.
Among the common procedures is distal pancreatectomy, which involves removal of the body and tail of the pancreas. 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 is one of the few organs that controls the immune function of the body, playing a key role in the natural defence against external bacterial threats.
“Without the spleen, either surgically removed or removed because of trauma or disease, patients are exposed to certain risks of infection,” he said.
He noted that traditional open surgery requires a large abdominal incision, which may result in significant postoperative pain, higher risk of wound infection and longer recovery time.
“The latest development is that we are moving into robotic surgery. With robotic surgery, surgeons operate through small incisions using robotic arms controlled from a console.
“The system provides a magnified three-dimensional projection of the internal organs through a camera, and surgeons control the robotic arms. This robotic arms has got a lot of degree of movement, mimicking natural human wrist, allowing better precision in such a tight space.
According to Dr Bong, 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 usually allows faster recovery, enabling patients to be mobile sooner. If no complication, patients may be discharged within seven to 10 days, and resume daily activities sooner,” he said.
On patient eligibility, Dr Bong said suitability for robotic or laparoscopic surgery depends on tumour’s location, size and whether major blood vessels are involved.
He also highlighted the growing practice of administering chemotherapy before surgery for selected pancreatic cancer patients.
“Neoadjuvant chemotherapy helps shrink the tumour and increases the likelihood of complete removal. This approach has been associated with improved long-term outcomes in appropriate cases,” he said.
Addressing common patient concerns, Dr Bong said many patients are worried about the risk of developing diabetes after pancreatic surgery.
“In the case of distal pancreatectomy, it depends on whether you are pre-diabetic to begin with, or normal person, or already diabetic. If you are already a diabetic, then the diabetic medication dose or the insulin will also need to increase. If the insulin demand is increased, your diabetes may temporarily worsen.
“If you are a normal person without history of diabetes, then it is very unlikely you will become diabetic because once the patient lost 50 per cent (of the pancreas), the other 50 per cent can still cope with the secretion of insulin and the enzymes,” he explained.
He also advised patients to adopt small, frequent meals and a high-protein, low-fat and less sugar diet in the early postoperative period to support recovery.
“This will allow the body to adjust to the new norm where the pancreas needs to adapt and compensate for loss of 50 per cent, and they can compensate and adjust to the new norm. Usually, with some dietary advice and teaching, we can usually achieve this quite successfully.
Dr Bong said that in the long run, most patients recover fully after robotic surgery, with only four tiny abdominal incisions as visible signs.
-- BERNAMA