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. 2018 Apr;80(2):118-122.
doi: 10.1007/s12262-017-1628-9. Epub 2017 Mar 20.

Robotic Pancreaticoduodenectomy: Technical Considerations

Marco Marino  1 , Gaspare Gulotta  1 , Andrzej L Komorowski  2
Affiliations

Robotic Pancreaticoduodenectomy: Technical Considerations

Marco Marino et al. Indian J Surg. 2018 Apr.

Erratum in

Abstract

Robotic surgery can help to overcome some technical limitations of laparoscopic pancreaticoduodenectomy thanks to EndoWrist instrumentations and the 3D view. Despite the potential benefits, its employment is still low and controversial. We focused on some important technical details crucial for a safe robotic pancreatectomy. After performing 52 robotic pancreatic resections that included 10 pancreatoduodenectomies, the authors describe their technique. The review of literature on robotic and laparoscopic duodenopancreatectomy is also performed in order to evaluate possible benefits of the robotic platform. We describe the step-by-step surgical procedure, analyzing all possible troubleshooting occurring in an initial center experience. The estimated blood loss as well as the length of stay was reduced by the robotic approach. We did not observe any significant increase of pancreatic fistula rate and all other postoperative complications despite our initial learning curve. Robotic pancreatoduodenectomy is a technically advanced procedure that requires important laparoscopic and robotic skills but it shows to be safe, feasible with some clear advantages in the bleeding control and in the reconstructive phase of the procedure.

Keywords: Learning curve; Operative technique; Pancreatic fistula; Robotic pancreatoduodenectomy.

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Conflict of interest statement

Compliance with Ethical StandardsThe authors declare that they have no conflict of interest.

Figures

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Fig. 1
Trocar/port placement
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Fig. 2
Full Kocher maneuver
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Fig. 3
Identification and isolation of the common hepatic artery, identification, and control of gastroduodenal artery
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Process of Wirsung’s duct visualization
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Fig. 5
Reconstructive phase of procedure
See this image and copyright information in PMC

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