Rather than making a horizontal 10-inch cut across Weppler’s stomach about six inches above his navel, Allamaneni made five cuts, each about one-third of an inch, into his abdomen and used a large four-armed robot to move Weppler’s organs so he could reach a tumor on his pancreas. Because the pancreas is located immediately in front of the spinal cord, surgeons cannot access it by cutting into the back of a patient’s body.
One of the robot’s four arms holds a small camera. The other three arms contain “graspers” used to move and hold organs, such as the stomach and liver, so Allamaneni could reach the pancreas and cut away the cancerous tissue.
Because of the smaller cuts, Weppler, 77, had significantly less pain and a quicker recovery.
“I think if it gives me a second chance at life, it’s a good thing,” Weppler said. “I had very, very, very little pain or discomfort.”
Without the surgery, Weppler’s life expectancy would have been six months to two years.
With a typical surgery for pancreatic cancer, a surgeon makes a 10- to 12-inch-long cut across the abdomen to reach the pancreas. Patients typically need to stay in the hospital five to 10 days to recover and may need to be on intravenous fluids up to five days before they can eat on their own.
Weppler was feeling good two days after surgery and once his pain medication wore off, he only needed Tylenol to relieve pain. Two days after surgery he was sitting up and visiting the bathroom.
“Everything went well,” Weppler said. “I was in the hospital for five days, came home and was able to walk and go to the bathroom. A lot of people said, ‘You wouldn’t have been able to do that,’” after the traditional surgery.
“They’re positive that they got it all,” said Candace Weppler, his wife of 35 years and a 1970 graduate of Hamilton’s Taft High School. Rick grew up in Cincinnati. “They want him to start chemo probably next month. His strength is coming back. He’s doing real well. "
The healing is wonderful,” Candace Weppler added. “All he has is five little incisions, and how they closed them was with glue. They didn’t even stitch him up or use staples, or anything.”
“Whipple surgery is among the most complex procedures for surgeons to perform,” Allamaneni said. “The pancreas’ location behind the stomach makes it hard to reach. The procedure involves not just removing the head of the pancreas, duodenum, gallbladder and parts of the stomach and bile duct, but also reconnecting narrow lumen ducts and organs afterward. It can be challenging to see these structures on which we are working, especially pancreatic duct, which only measures a few millimeters in diameter.”
The surgery lasted about seven hours.
Allamaneni said the robotic arms allow delicate movements and have more range of motion than the human wrist and arms, with the camera magnifying the tiny tissues.
“I make a two-inch incision at the end of the procedure to remove the specimen,” he said. “Smaller incisions mean a shorter recovery time of three-to-five days, and patients should be able to drink and eat in one or two days. Smaller incisions also mean reduced pain following surgery and less risk of surface infection at the incision site.”
Allamaneni practices from Mercy Health Kenwood Surgical Oncology and General Surgery, and performs robotic liver resections, distal pancreatectomy, gastrectomy, adrenalectomy and other complex cancer surgeries.
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