Related Experiment Video
Updated: Jun 22, 2025
Technical Detail for Robot Assisted Pancreaticoduodenectomy
Published on: September 28, 2019
Robotic Pancreatoduodenectomy: Increasing Complexity and Decreasing Complications with Experience: Single-Center
Marcel Autran C Machado1, Bruno V Mattos2, Murillo Macedo Lobo Filho2
1Nove de Julho Hospital, São Paulo, Brazil. dr@drmarcel.com.br.
Background:
This report describes the authors' experience with 150 consecutive robotic pancreatoduodenectomies.
Methods:
The study enrolled 150 consecutive patients who underwent robotic pancreatoduodenectomy between 2018 and 2023. Pre- and intraoperative variables such as age, gender, indication, operation time, diagnosis, and tumor size were analyzed. The patients were divided into two groups. Group 1 comprised the first 75 patients, and group 2 comprised the last 75 cases. The median age of the patients was 62.4 years and did not differ between the two groups.
Results:
Morbidity was lower in group 2. The mortality rate was 0.7% at 30 days and 1.3% at 90 days, and there was no difference between the groups. There was a significant reduction (p < 0.05) in operative time, resection time, reconstruction time, and conversion to open surgery in group 2. Partial resection of the portal vein was performed in 17 patients and more common in group 2 (p < 0.01). The number of resected lymph nodes was higher in group 2. The indication for pancreatoduodenectomy did not differ between the two groups. There was no difference in tumor size or clinical characteristics of the patients.
Conclusions:
The robotic platform is useful for pancreatoduodenectomy, facilitates adequate lymphadenectomy, and is helpful for digestive tract reconstruction after resection. Robotic pancreatoduodenectomy is safe and feasible for selected patients. It should be performed in specialized centers by surgeons experienced in open and minimally invasive pancreatic surgery.
Insights
Robotic pancreatoduodenectomy improved surgical outcomes, reducing operative time and morbidity. This minimally invasive approach is safe and feasible for selected patients in experienced centers.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Robotic surgery is increasingly adopted for complex gastrointestinal procedures.
- Pancreatoduodenectomy remains a challenging operation with significant morbidity.
- Evaluating the learning curve and outcomes of robotic pancreatoduodenectomy is crucial.
Purpose of the Study:
- To assess the safety and feasibility of robotic pancreatoduodenectomy.
- To analyze the learning curve and compare outcomes between early and later cases.
- To evaluate the impact of robotic platform on operative efficiency and patient morbidity.
Main Methods:
- Retrospective analysis of 150 consecutive robotic pancreatoduodenectomies (2018-2023).
- Patients divided into two groups: first 75 (Group 1) and last 75 (Group 2).
- Comparison of pre- and intraoperative variables, including operative time, morbidity, and lymphadenectomy yield.
Main Results:
- Group 2 demonstrated significantly reduced operative time, resection time, reconstruction time, and conversion rates.
- Morbidity was lower in Group 2, with no significant difference in mortality rates.
- Increased lymph node yield and more frequent portal vein resection were observed in Group 2.
Conclusions:
- The robotic platform enhances pancreatoduodenectomy by facilitating lymphadenectomy and reconstruction.
- Robotic pancreatoduodenectomy is a safe and feasible option for selected patients.
- Experience and specialized centers are key for successful robotic pancreatic surgery outcomes.
Related Concept Videos
01:26Endoscopic Procedures V: ERCP
Patient...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment: