Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Robotic pancreaticoduodenectomy (RPD) presents a less invasive alternative to open pancreaticoduodenectomy (OPD).
• Concerns exist regarding RPD's technical demands, cost, and oncologic effectiveness.
• Evaluating RPD's role in pancreatic cancer treatment is crucial.

Purpose of the Study:

• To systematically review the literature on robotic pancreaticoduodenectomy (RPD).
• To assess perioperative outcomes, oncologic adequacy, and the learning curve for RPD.
• To explore cost-effectiveness and future advancements in RPD.

Main Methods:

• Comprehensive database search (PubMed, MEDLINE, Scopus, Embase) from January 2000 to October 2025.
• Focus on systematic reviews, meta-analyses, and comparative studies of RPD.
• Analysis of perioperative results, oncologic sufficiency, learning curve, and cost.

Main Results:

• RPD demonstrates comparable R0 resection rates and lymph node yield to OPD.
• Reduced blood loss, shorter hospital stays, and faster recovery are noted in high-volume centers.
• Morbidity and mortality rates are similar to open/laparoscopic approaches; competence achieved after 40-60 cases.

Conclusions:

• RPD is a safe and effective option for select patients in specialized, high-volume centers.
• Further research is needed on long-term oncologic outcomes and cost-effectiveness.
• Next-generation robotic systems may enhance RPD's accuracy and efficiency.