Robotic Pancreaticoduodenectomy: Single-Surgeon Initial Experience

Area of Science:

• Minimally invasive surgery
• Surgical oncology
• Robotic surgery

Background:

• Minimally invasive surgery is increasingly adopted for complex procedures like pancreaticoduodenectomy.
• Laparoscopic pancreaticoduodenectomy requires instrument adaptation.
• Robotic systems offer enhanced dexterity for minimally invasive surgery.

Purpose of the Study:

• To report the initial experience with totally robotic pancreaticoduodenectomy.
• To evaluate the safety and feasibility of this robotic approach.

Main Methods:

• Retrospective review of four patients undergoing totally robotic pancreaticoduodenectomy (or total pancreatectomy).
• Data collected included demographics, perioperative details, and pathological results.
• Procedures performed between April 2015 and August 2015.

Main Results:

• Average age was 56.8 years.
• Mean operation time was 563 minutes with average blood loss of 228 mL.
• No blood transfusions, conversions to open surgery, or postoperative analgesia were required. Postoperative recovery was uneventful with a mean hospital stay of 10 days. No 30-day mortality or readmissions occurred.

Conclusions:

• Totally robotic pancreaticoduodenectomy is safe and feasible in experienced hands for selected patients.
• Acceptable short-term outcomes and oncological results were observed.
• Further studies on long-term outcomes, cost-effectiveness, and learning curve are necessary for widespread adoption.