This operative video demonstrates a robotic distal pancreatectomy and splenectomy performed for a biopsy-proven pancreatic neuroendocrine tumor (PNET) involving the distal body and tail of the pancreas.

The patient is a 77-year-old woman with a medical history notable for hypertension, hyperlipidemia, osteopenia, and prior stage T1bcN0 grade 1 ER/PR-positive, HER2-nonamplified invasive ductal carcinoma of the breast treated with lumpectomy and endocrine therapy.

She presented with abdominal pain, and diagnostic evaluation revealed a 4 cm non-functional, well-differentiated neuroendocrine tumor of the distal pancreas without radiographic evidence of metastatic disease.

The patient underwent robotic distal pancreatectomy and splenectomy.

Final pathology demonstrated:

• pT2 pN1 well-differentiated neuroendocrine tumor

• Ki-67 index 1.2% (grade 1)

• 2 of 13 lymph nodes involved with tumor

• Lymphovascular invasion present

• Negative surgical margins

The patient recovered well following surgery and was discharged home on postoperative day three with a surgical drain in place, which was removed during the first postoperative clinic visit.

This case demonstrates the use of robotic minimally invasive techniques in pancreatic neuroendocrine tumor surgery, allowing precise dissection and lymphadenectomy while maintaining strict oncologic principles.