Robotic pancreatic resection. Personal experience with 105 cases

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• The first robotic pancreatic resection in Brazil was performed in 2008.
• Since March 2018, a policy mandated systematic robotic use in all minimally invasive pancreatic surgeries.

Purpose of the Study:

• To review the institutional experience with robotic pancreatic resection.
• To assess the safety and feasibility of robotic pancreatic surgery in a Brazilian cohort.

Main Methods:

• Retrospective review of 105 patients undergoing robotic pancreatic resection from March 2018 to December 2019.
• Data collected included preoperative (age, sex, indication), intraoperative (operative time, bleeding, transfusion), and postoperative variables.

Main Results:

• 105 patients underwent robotic pancreatectomy, with 51 pancreatoduodenectomies and 34 distal pancreatectomies.
• Overall morbidity was 23.8%, primarily due to pancreatic fistula. Mortality was 0.9% (one death).
• Conversion to open surgery occurred in 2.8% of cases; no patient required reintervention or readmission.

Conclusions:

• Robotic platform is effective for reconstruction after pancreatoduodenectomy and central pancreatectomy.
• Robotic surgery may enhance spleen preservation during distal pancreatectomies.
• Robotic pancreatic resection is safe and feasible for selected patients in experienced centers.