The robotic Whipple: operative strategy and technical considerations

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic surgical systems offer enhanced dexterity and visualization for complex procedures.
• Minimally invasive approaches to pancreatic surgery are gaining traction.
• The Whipple procedure remains a challenging operation with significant morbidity.

Purpose of the Study:

• To present a detailed, step-by-step approach for performing the robotic Whipple procedure.
• To outline critical surgical steps including port placement, dissection, and reconstruction.
• To report initial clinical experience with the robotic Whipple procedure.

Main Methods:

• A comprehensive description of the robotic Whipple procedure, covering port setup, instrument docking, and key anatomical dissections.
• Detailed explanation of techniques for kocherization, superior mesenteric vein identification, portal dissection, and ligament of Treitz release.
• Step-by-step guide to uncinate dissection and reconstruction phases of the procedure.

Main Results:

• The study outlines a standardized approach to the robotic Whipple procedure.
• Initial 2-year experience with the robotic Whipple procedure is briefly reported.
• The presented methodology facilitates a structured execution of the operation.

Conclusions:

• Robotic technology enables a refined approach to the Whipple procedure, enhancing minimally invasive capabilities.
• The step-by-step methodology provides a valuable educational resource for surgeons.
• Further evaluation of long-term outcomes is warranted for robotic Whipple procedures.