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Updated: Apr 27, 2026

Robotic Spleen-Preserving Distal Pancreatectomy: The Warshaw and Kimura Techniques
Published on: July 26, 2024
Robotic Spleen-Preserving Distal Pancreatectomy: Perioperative Outcomes and Comparison of Two Energy Devices
Yusheng Du1, Ji Wang1, Li Liu1
1Department of Pancreatic Surgery, The First Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Background:
We evaluated the perioperative outcomes of robotic spleen-preserving distal pancreatectomy (RSPDP) and compared articulated monopolar curved scissors (R-MCS) with the harmonic scalpel (R-HS) as the primary energy device.
Methods:
We retrospectively reviewed consecutive single-centre RSPDPs (September 2020-August 2025) and compared baseline characteristics, intraoperative variables, and postoperative outcomes.
Results:
Sixty-nine patients were included (R-MCS, n = 31; R-HS, n = 38). Overall spleen preservation was 79.7%, with no between-group difference (80.6% vs. 78.9%, p = 0.852). Among spleen-preserved cases, Kimura completion was higher with R-MCS (88.0% vs. 66.7%, p = 0.032). Operative time and blood loss were comparable. Time to first flatus was shorter with R-MCS (3.2 ± 0.9 vs. 3.7 ± 0.7 days, p = 0.014). Overall complications occurred in 18.8%, including clinically relevant postoperative pancreatic fistula in 11.6%; no Clavien-Dindo grade ≥ IIIb complications or perioperative mortality occurred.
Conclusion:
RSPDP is safe and feasible. R-MCS may improve Kimura completion and modestly shorten the time to first flatus, pending further validation.

