Robotic antrum-pyloric resection with intracorporeal anastomosis in a young woman with ectopic pancreas pyloric stenosis

Ectopic pancreas is pancreatic tissue sited outside its normal location and lacking anatomic or vascular connection with eutopic pancreatic tissue. We present herein a successful robotic antrum-pyloric resection with intracorporeal Roux-en-Y reconstruction in a 24-year-old woman. The patient was admitted for recent worsening vomiting, intermittent epigastric pain, and hyporexia that arose some years previous. Endoscopic ultrasonography (EUS) findings suggested the presence of ectopic pancreas but did not exclude the possibility of gastrointestinal stromal tumor (GIST) or other pathogenesis. Totally robotic (three-arm da Vinci®) antrum-pyloric resection was decided. Final pathologic analysis revealed that the lesion comprised exocrine pancreas located in the submucosal layer. Patient was discharged on the 10th postoperative day. Robotic antrum-pyloric resection was decided considering its advantages over laparoscopy including stereoscopic vision, loss of tremor, and robotic arm endowrist. These instrumental benefits facilitate procedures such as knot-tying, suturing, organ manipulation, and tissue dissection. We show that subtotal gastrectomy for ectopic pancreas can be performed robotically and is a feasible and safe procedure.