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Robotic Parenchymal-Sparing Pancreatectomy: A Systematic Review
Richard Zheng1, Elie Ghabi1, Jin He1
1Department of Surgery, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD 21287, USA.
Cancers
|September 9, 2023
Summary
Robotic parenchymal-sparing pancreatectomy offers a way to preserve the pancreas, but may increase the risk of pancreatic fistulas. However, severe or long-term complications are rare, making it a viable option for select patients.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Parenchymal-sparing pancreatectomy aims to preserve pancreatic function and reduce insufficiency.
- Robotic platforms are increasingly utilized for complex pancreatic surgeries.
- Evaluating robotic approaches is crucial for optimizing patient outcomes.
Purpose of the Study:
- To assess the efficacy and complication profile of robotic parenchymal-sparing pancreatectomy.
- To compare robotic techniques with traditional open approaches.
- To identify patient selection criteria for robotic parenchymal-sparing pancreatectomy.
Main Methods:
- Systematic review of studies on robotic parenchymal-sparing pancreatectomy (2001-2022).
- Included procedures: central pancreatectomy, duodenum-preserving pancreatic head resection, enucleation, uncinate resection.
- Databases searched: PubMed and Embase.
Main Results:
- 23 studies with 788 patients were analyzed.
- Robotic procedures showed longer operative times but shorter hospital stays and higher blood loss than open surgery.
- Postoperative pancreatic fistulas were common, but severe complications were rare; long-term endocrine/exocrine insufficiency was minimal.
Conclusions:
- Robotic parenchymal-sparing pancreatectomy has a higher risk of pancreatic fistula but low rates of severe/long-term complications.
- Careful patient selection is essential for maximizing benefits and minimizing morbidity.
- This approach is suitable for benign or indolent pancreatic lesions worldwide.
