A 77-year-old woman with a family history of pancreatic cancer and a personal history of cerebrovascular accidentpresented with a biopsy-proven pancreatic ductal adenocarcinoma located in the distal pancreatic neck/proximal body.

Initial staging demonstrated borderline-resectable disease (Type C). She therefore underwent neoadjuvant systemic therapy with gemcitabine and nab-paclitaxel, completing four cycles with favorable radiographic response and improvement in tumor markers, suggesting adequate disease control and candidacy for surgical resection.

Following multidisciplinary review, the patient proceeded to robotic resection using the da Vinci 5 platform.

The operation consisted of:

• Robotic staging and exploration

• Robotic subtotal distal pancreatectomy

• Splenectomy

• Cholecystectomy

The procedure was completed minimally invasively without conversion.

Final pathology demonstrated:

• Pancreatic ductal adenocarcinoma

• pT2 pN0 disease

• 0 of 18 lymph nodes involved

• Negative resection margins (R0)

The patient's postoperative course was uneventful. She recovered well and was discharged home on postoperative day three.

This case illustrates the application of robotic pancreatic resection following neoadjuvant therapy for borderline-resectable pancreatic cancer, demonstrating the ability to achieve oncologically sound resection with lymph node evaluation and margin-negative surgery while maintaining the benefits of minimally invasive recovery.