The Whipple Procedure

Anusak Yiengpruksawan, M.D., Director of Surgical Oncology at The Valley Hospital, performed the first fully robotic Whipple procedure in the United States. Traditionally done as open surgery, the Whipple is a complicated procedure used to remove tumors of the pancreas. The operation generally involves removal of the gallbladder, bile duct, part of the small intestine, and head of the pancreas.

"Surgery is the only effective therapy for pancreatic cancer, but the procedure must be performed by a specially trained surgeon," says Dr. Yiengpruksawan. "The Whipple is considered the 'Everest' of surgery."

The Whipple procedure is the most commonly performed operation for pancreatic cancer, the fourth leading cause of cancer death in the U.S. While survival rates for the procedure are rising, they are much greater at high-volume centers. The Valley Hospital, one of a limited number of institutions regarded as high-volume for pancreatic surgery, treats more patients with the disease than any other area hospital.

For patients with benign as well as malignant pancreatic tumors, the robotic Whipple procedure is an improvement over the traditional procedure. The newer surgery involves several small incisions (one to accommodate a miniature camera), rather than a large incision, and separation, not cutting of muscles. Patients have a shorter hospital stay, less pain, less risk of complications, faster recovery time, and a quicker return to normal activities.

To perform the procedure, which requires special expertise, including knowledge of minimally invasive techniques, Dr. Yiengpruksawan sits at a console, viewing a three-dimensional image of the surgical field and manipulating small flexible instruments inserted through the incisions.

"The robotic camera allows for magnified, high definition viewing of organs," says Dr. Yiengpruksawan, who also serves as Director of the Center for Minimally Invasive and Robotic Surgery at Valley. "It results in a very meticulous operation."

Elaine Gardner, of Hawthorne, exemplifies the benefits of the new procedure. Mrs. Gardner had a benign tumor of the pancreas, discovered on a CT scan that she underwent because of symptoms unrelated to the tumor. She was an ideal candidate for the new procedure since her tumor was confined to the head of the pancreas.

"I didn't know that I would be having the robotic procedure until a day before the surgery. It was 100 percent better than what I had been anticipating," says Mrs. Gardner. "Dr. Yiengpruksawan is a warm and compassionate doctor. He's my hero."

Mrs. Gardener was in the hospital for five days, a stay Dr. Yiengpruksawan says is the shortest he has seen with the Whipple procedure. If Mrs. Gardner had had traditional open surgery, she probably would have been in the hospital for 14 days.

"I'm feeling better every day," says Mrs. Gardner, who arrived home in time for the arrival of her first grandchild. "I'm happy to be home and glad I'm alive."

For more information, please contact Valley's Institute for Robotic and Minimally Invasive Surgery at 201-447-8012 or e-mail us at dgerard@valleyhealth.com.