| Recently, there has been a rise of interest in minimal invasive surgery of pancreas. Laparoscopic distal pancreatectomy for benign or borderline malignant disease is well established and becoming well accepted in clinical practice. However, there still debates using laparoscopy in malignant disease of the pancreas. Laparoscopic surgery has been applied in various types of malignancy, such as colorectal cancer, gastric cancer and even hepatocellular carcinoma. Several well designed studies have shown equivalent outcomes after laparoscopic surgery for those cancers. However, the studies on laparoscopic surgery on pancreas cancer are still scarce. The plausible reasons for this lacks of study may be relative small number of cases of resectable pancreas cancer, technical difficulty of laparoscopic surgery, and cautious application of this procedure to malignant disease. Therefore, the laparoscopic surgery for pancreas cancer is not yet standard procedure in current situation. Even though the reports on the laparoscopic distal pancreatectomy are still scare, most of the report show that outcomes are similar to open surgery. Laparoscopic pancreaticoduodenectomy is still not widely performed due to technical difficulty as well. The application of this procedure to pancreas cancer is still not reported in full scale. There are a few reports that showed encouraging outcomes. Robot assisted procedure will be one way to overcome the learning curve. Although the progress in still slow, minimal invasive surgery for pancreas cancer will be accepted in the future. |
