International consensus statement on robotic pancreatic surgery

Rong Liu¹, Go Wakabayashi², Chinnusamy Palanivelu³, Allan Tsung⁴, Kehu Yang⁵, Brian K P Goh⁶, Charing Ching-Ning Chong⁷, Chang Moo Kang⁸, Chenghong Peng⁹, Eli Kakiashvili¹⁰, Ho-Seong Han¹¹, Hong-Jin Kim¹², Jin He¹³, Jae Hoon Lee¹⁴, Kyoichi Takaori¹⁵, Marco Vito Marino¹⁶, Shen-Nien Wang¹⁷, Tiankang Guo¹⁸, Thilo Hackert¹⁹, Ting-Shuo Huang²⁰, Yiengpruksawan Anusak²¹, Yuman Fong²², Yuichi Nagakawa²³, Yi-Ming Shyr²⁴, Yao-Ming Wu²⁵, Yupei Zhao²⁶

Affiliations

¹ Department of Hepatopancreatobiliary Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China.
² Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Ageo, Japan.
³ Division of Gastrointestinal Surgery and Minimal Access Surgery, GEM Hospital and Research Centre, Coimbatore, India.
⁴ Division of Surgical Oncology, Gastrointestinal Disease Specific Research Group, The Ohio State University Wexner Medical Center Department of Surgery, Columbus, OH, USA.
⁵ Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
⁶ Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
⁷ Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
⁸ Division of HBP Surgery, Yonsei University College of Medicine, Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
⁹ Pancreatic Disease Centre, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
¹⁰ Department of General Surgery, Galilee Medical Center, Nahariya, Israel.
¹¹ Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
¹² Department of Surgery, Yeungnam University Hospital, Daegu, Korea.
¹³ Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
¹⁴ Division of Hepatobiliary & Pancreas Surgery, Department of Surgery, Asan Medical Center, Seoul, Korea.
¹⁵ Department of Surgery, Kyoto University Hospital, Shogoin, Sakyo-Ku, Kyoto, Japan.
¹⁶ Department of General Surgery, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
¹⁷ Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung.
¹⁸ Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730030, China.
¹⁹ Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
²⁰ Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung.
²¹ Minimally Invasive Surgery Division, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
²² Department of Surgery, City of Hope Medical Center, Duarte, CA, USA.
²³ Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
²⁴ Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, Taipei.
²⁵ Department of Surgery, National Taiwan University Hospital, Taipei.
²⁶ Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

PMID: 31489304
PMCID: PMC6700012
DOI: 10.21037/hbsn.2019.07.08

Review

International consensus statement on robotic pancreatic surgery

Rong Liu et al. Hepatobiliary Surg Nutr. 2019 Aug.

. 2019 Aug;8(4):345-360.

doi: 10.21037/hbsn.2019.07.08.

Authors

Affiliations

¹ Department of Hepatopancreatobiliary Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China.
² Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Ageo, Japan.
³ Division of Gastrointestinal Surgery and Minimal Access Surgery, GEM Hospital and Research Centre, Coimbatore, India.
⁴ Division of Surgical Oncology, Gastrointestinal Disease Specific Research Group, The Ohio State University Wexner Medical Center Department of Surgery, Columbus, OH, USA.
⁵ Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
⁶ Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
⁷ Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
⁸ Division of HBP Surgery, Yonsei University College of Medicine, Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
⁹ Pancreatic Disease Centre, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
¹⁰ Department of General Surgery, Galilee Medical Center, Nahariya, Israel.
¹¹ Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
¹² Department of Surgery, Yeungnam University Hospital, Daegu, Korea.
¹³ Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
¹⁴ Division of Hepatobiliary & Pancreas Surgery, Department of Surgery, Asan Medical Center, Seoul, Korea.
¹⁵ Department of Surgery, Kyoto University Hospital, Shogoin, Sakyo-Ku, Kyoto, Japan.
¹⁶ Department of General Surgery, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
¹⁷ Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung.
¹⁸ Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730030, China.
¹⁹ Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
²⁰ Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung.
²¹ Minimally Invasive Surgery Division, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
²² Department of Surgery, City of Hope Medical Center, Duarte, CA, USA.
²³ Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
²⁴ Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, Taipei.
²⁵ Department of Surgery, National Taiwan University Hospital, Taipei.
²⁶ Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

PMID: 31489304
PMCID: PMC6700012
DOI: 10.21037/hbsn.2019.07.08

Abstract

The robotic surgical system has been applied to various types of pancreatic surgery. However, controversies exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts' consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group* and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 19 topics were analyzed. The first 16 recommendations were generated by GRADE using an evidence-based method (EBM) and focused on the safety, feasibility, indication, techniques, certification of the robotic surgeon, and cost-effectiveness of robotic pancreatic surgery. The remaining three recommendations were based on literature review and expert panel opinion due to insufficient EBM results. Since the current amount of evidence was low/meager as evaluated by the GRADE method, further randomized controlled trials (RCTs) are needed in the future to validate these recommendations.

Keywords: Robotic surgery; consensus statement; pancreatectomy; pancreatic enucleation; pancreaticoduodenectomy.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

**Figure 1**
The flow chart illustrates the process of consensus development.

See this image and copyright information in PMC

Comment in

Is robotic pancreatic surgery finally ready for prime-time?
Gumbs AA, Croner R, Chouillard E. Gumbs AA, et al. Hepatobiliary Surg Nutr. 2020 Oct;9(5):650-653. doi: 10.21037/hbsn.2019.12.05. Hepatobiliary Surg Nutr. 2020. PMID: 33163516 Free PMC article. No abstract available.
Robotic pancreatic surgery: a slowly developing field.
Salibi PN, Martinie JB. Salibi PN, et al. Hepatobiliary Surg Nutr. 2020 Oct;9(5):673-675. doi: 10.21037/hbsn.2020.02.02. Hepatobiliary Surg Nutr. 2020. PMID: 33163522 Free PMC article. No abstract available.

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International consensus statement on robotic pancreatic surgery

Affiliations

International consensus statement on robotic pancreatic surgery

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Comment in

References

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Medical