Robotic pancreatic surgery: old concerns, new perspectives

Acta Chir Belg. 2019 Feb;119(1):16-23. doi: 10.1080/00015458.2018.1444550. Epub 2018 Mar 8.

Abstract

Background: Described for the first time in 2003, the robotic pancreatic surgery shows interesting results. The evaluation of post-operative outcomes is necessary once we describe an innovative surgical approach.

Methods: We have performed a retrospective analysis of a prospectively maintained database on robotic pancreatic surgery including malignant and benign indications for surgery.

Results: A total of 50 consecutive patients underwent robotic pancreatic surgery (26 pancreatico duodenectomy and 24 distal pancreatectomy) between January 2012 and July 2015 in a single centre. The overall operative time was 425 (390-620) min. In a subgroup of highly selected malignant tumours, we were able to achieve 88% of R0 resection with robotic approach. A number of lymphnodes rose significantly with growing experience (p = .025). The overall major complication rate (15%), as well as pancreatic fistula rate (16%) were acceptable. The two-year overall survival for the whole group was 65%.

Conclusion: The robotic pancreatic surgery in a highly selected group of patients seems safe and feasible. The cost-effectiveness and long-term oncologic outcomes need further investigations.

Keywords: Robotic pancreatic surgery; distal pancreatectomy; pancreatic fistula; pancreaticoduodenectomy; postoperative complications.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Pancreatectomy
  • Pancreatic Diseases / mortality
  • Pancreatic Diseases / surgery*
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / statistics & numerical data*
  • Survival Rate
  • Treatment Outcome