In a landmark surgical achievement, a team at Burjeel Medical City (BMC) successfully performed a totally robotic Whipple pancreatoduodenectomy, showcasing the hospital’s cutting-edge technical capabilities and specialized expertise in complex surgical interventions.
Patient Journey
The patient, an Emirati woman with previous breast cancer history, presented with abnormal liver function tests during routine follow-up. Comprehensive diagnostic imaging—including abdominal ultrasound, CT scan, MRI, and endoscopy—revealed a blocked biliary system causing jaundice. The blockage was located at the lower end of her bilio-pancreatic ductal system, specifically at the ampulla region.
Endoscopic evaluation identified a small tumor in the periampullary region, with biopsy confirming periampullary cancer blocking both bile and pancreatic ducts. Further workup confirmed the absence of metastatic spread, making her an ideal candidate for surgical intervention.
Advanced Surgical Approach
“The Whipple procedure is the most complex surgery of the gastrointestinal system,” explains Dr. Ali Iyoob, Consultant & HOD of Gastro-intestinal Surgery at Burjeel Medical City. “Using the technically most demanding robot for this type of surgery is the real challenge.”
Following evaluation at BMC’s multidisciplinary tumor board, the surgical team recommended a minimally invasive approach using the da Vinci Xi Robotic System—a significant advancement over traditional open surgery techniques.
The procedure involves removing:
- Bile duct
- Gallbladder
- Portion of the pancreas
- Duodenum
- Part of the stomach
- Part of the small intestine
- Regional lymph nodes
Following removal, the surgical team meticulously reconstructs the digestive pathway to restore normal function.
Technical Innovations
What distinguishes this procedure is that it was performed entirely using the da Vinci Xi Robot, making it a truly unique surgical achievement. Very few medical centers worldwide have the capability to perform a totally robotic Whipple procedure.
The robotic approach offers significant advantages over both traditional open surgery and laparoscopic techniques:
- Enhanced 3D magnification for surgeons
- Superior dexterity and precision
- Finer tissue manipulation
- Better cancer clearance
- Enhanced lymph node harvesting
- Reduced complications
Successful Outcome
The surgical procedure lasted approximately 500 minutes and proceeded without complications. Postoperative recovery was remarkably smooth, with the patient being able to begin oral nutrition after just 24 hours. She was discharged after 9 days with excellent wound healing and has since returned to a normal diet.
“The reconstruction and joining of pancreas and bile duct to the digestive pathway is the most challenging aspect of this surgery,” notes Dr. Iyoob. “Using the da Vinci Robot, this can be accomplished with minimal risk of leakage complications.”
The surgical team included Dr. Bipin Thomas Prasad, Specialist in General Surgery, and Dr. Murali Shankar, Consultant Anesthesiologist, highlighting the multidisciplinary approach essential for such complex procedures.
This case demonstrates Burjeel Medical City’s position at the forefront of adopting advanced robotic surgical techniques, offering patients in the UAE and Gulf region access to world-class minimally invasive surgical options for even the most complex conditions.
