Inframesocolic Approach for Robotic Enucleation of Branch-Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas.

Background: The inframesocolic approach to the uncinate process of the pancreas has been rarely described in literature. To the best of our knowledge, no robotic cases have been reported.

Methods: The case of a 74-year-old woman, with a 43-mm branch-duct intraductal papillary mucinous neoplasm with worrisome features within the uncinate process of the pancreas, is described.

Results: After diagnostic work-up, due to the uncertain potential of malignancy and the strong motivation of the patient to undergo surgery, we performed a robotic enucleation through an inframesocolic approach. The neoplasm was more than 1 cm from the main pancreatic duct. Final pathological diagnosis revealed a low-grade dysplasia branch-duct intraductal papillary mucinous neoplasm.

Conclusions: The inframesocolic approach could represent an easy way to access the uncinate process of the pancreas, allowing safe limited resection in selected cases such as small branch-duct IPMN or pancreatic neuroendocrine tumors.