Robotic Stapler Lateral Pancreaticojejunostomy: A Newer Technique for Old Surgery

Lateral pancreaticojejunostomy (LPJ) also known as the modified Puestow procedure is a complex surgical procedure reserved for patients with refractory chronic pancreatitis (CP) or a dilated pancreatic duct.There is a shift toward adopting minimally invasive techniques for performing this surgery, with laparoscopy already gaining popularity.The robotic approach, though not popular at present, appears to have an advantage over the laparoscopic techniques in better visualization through three-dimensional (3D) imaging and availability of twisted instruments with 7 degrees freedom of movement for more precise action, which may translate into superior outcome.Additionally, using Endo stapler for pancreaticojejunostomy is a viable alternative in grossly dilated ducts with a diameter of more than 12 mm.It leads to reduced operative times and fewer complications.This case report presents our technique for Robotic LPJ with stapler anastomosis.With no reports in the literature for the use of staplers in robotic LPJ, this report has an important role in suggesting the advantages, safety, and feasibility of this newer technique.