Comparison of surgical outcomes between open and robot‐assisted minimally invasive pancreaticoduodenectomy

Kim, Hyeong Seok; Han, Youngmin; Kang, Jae Seung; Kim, Hongbeom; Kim, Jae Ri; Koon, Wooil; Kim, Sun Whe; Jang, Jin Young

doi:10.1002/jhbp.522

Cited by 50 publications

(52 citation statements)

References 38 publications

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“…Therefore, RAPD surgery is more advantageous than LPD surgery. Recent reports have shown that RAPD is safer and more efficient than LPD among properly selected patients 11,12 . Therefore, RAPD is technically a feasible alternative to the laparoscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Zhou

Miao

et al. 2020

Sci Rep

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to analyze the initial learning curve (Lc) for robot-assisted pancreaticoduodenectomy (RApD) and compare RApD during the initial Lc with open pancreaticoduodenectomy (opD) in terms of outcome. this study is a retrospective review of patients who consecutively underwent RApD and opD between October 2015 and January 2020 in our hospital. 41 consecutive RAPD cases and 53 consecutive open cases were enrolled for review. Compared with OPD, RAPD required a significantly longer operative time (401.1 ± 127.5 vs. 230.8 ± 44.5 min, P < 0.001) and higher cost (194621 ± 78342 vs. 121874 ± 39973 CNY, P < 0.001). Moreover, compared with the OPD group, the RAPD group revealed a significantly smaller mean number of lymph nodes harvested in malignant cases (15.6 ± 5.9 vs 18.9 ± 7.3, P = 0.025). No statistically significant differences were observed between the two groups in terms of incidence of Clavien-Dindo grade III-V morbidities and 90-day mortality and readmission (p>0.05). In the CUSUM graph, one peak point was observed at the 8th case, after which the operation time began to decrease. LC for RAPD may be less than 30 cases, and RAPD is safe and feasible during the initial Lc. Although pancreatectomy was first performed 80 years ago, it remains a challenging abdominal surgery with relatively high morbidity and mortality 1. Laparoscopic pancreaticoduodenectomy (LPD) was first reported in 1994 by Gagner 2 ; today, this procedure could be performed as safely as open pancreaticoduodenectomy (OPD) by skilled surgeons 3,4. However, the long learning curve (LC) for LPD continues to challenge many surgeons. In general, LPD presents intrinsic disadvantages compared with conventional laparotomy, including instrument motion, two-dimensional imaging, poor surgeon ergonomics, and a long LC. In 2000, the Da Vinci system was approved by the Food and Drug Administration. In 2003, Giulianotti et al. published a case series verifying the feasibility of robotic pancreatectomy; the series included eight robot-assisted pancreaticoduodenectomy (RAPD) and five robot-assisted distal pancreatectomy (RADP) cases 5. Robotic surgery is an advanced minimally invasive surgical technique that has several benefits in pancreaticoduodenectomy, such as enhanced three-dimensional vision, application of EndoWrist instruments (which have a great range of motion), and a short LC. However, the safety of RAPD during the initial LC and the possible shortening of the LC remain unclear. Therefore, this article addresses the LC of a single surgical team in our hospital. Methods patient Selection. This study is a retrospective research on pancreaticoduodenectomy conducted by a single surgical team. Our team had performed over 200 OPD before

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Section: Discussionmentioning

confidence: 99%

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Zhou

Miao

et al. 2020

Sci Rep

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“…Robotic pancreas surgery (Table 4) [24][25][26][27][28][29][30][31][32] Robotic pancreas surgery can be divided into two main groups: resection only and resection followed by reconstruction.…”

Section: Resultsmentioning

confidence: 99%

Robotic surgery for liver, pancreas, and bile duct pathologies: A critical analysis and personal views

Matteotti

2019

Gastrointestinal Intervention

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At the beginning of this millennium robotic surgery was launched and quickly became accepted in many surgical specialties. Initially only resection procedures were performed with a few surgical steps made towards reconstructive elements. Robotic surgery helped to overcome disadvantages seen and experienced when performing laparoscopic procedures, mainly lack of haptic feedback, lack of 'free movement' in the abdominal cavity and inferior visualization. Since its initiation, robotic surgery was utilized more and more in complex procedures. Its use in complex liver and pancreatic surgery is still controversial as it requires a high volume center and superb training to achieve acceptable results. Robotic surgery for hepato-pancreato-biliary disease is only performed by a few centers in the United States. A team approach is mandatory and the bed side assistant is as important as the console surgeon in achieving acceptable oncological outcome. This article aims to review the most recent literature and gives some personal views into the near future with anticipated development of this exciting technology.

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“…Multiple single or multi-institutional retrospective studies to compare specific outcomes between robotic, laparoscopic and open approaches are reported [6,[14][15][16][18][19][20][21][22][23][24] . A large systematic review examined data from 13 retrospective series [25] .…”

Section: Discussionmentioning

confidence: 99%

Robotic pancreaticoduodenectomy and splenopancreatectomy: technical aspects and review of literature

Tschuor¹,

Nagarkatti²,

Salibi³

et al. 2020

Mini-invasive Surg

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Robotic pancreatic surgery provides several advantages. Since the first report of a robotic-assisted distal pancreatectomy in 2001, total pancreatectomies, pancreatic tumor enucleations, pancreaticoduodenectomy, central pancreatectomy and Appleby procedures have been performed, indicating a promising future. The aim of this article is to describe our experience of robotic pancreatic surgery including technical aspects for pancreaticoduodenectomy and distal pancreatectomy. The current literature on feasibility, safety and early postoperative outcomes will be discussed.

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Comparison of surgical outcomes between open and robot‐assisted minimally invasive pancreaticoduodenectomy

Abstract: Robot PD is comparable to open PD in early outcomes. Robot PD is safe and feasible and enables early recovery; indication for robot PD is expected to expand in the near future.

Cited by 50 publications

References 38 publications

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Robotic surgery for liver, pancreas, and bile duct pathologies: A critical analysis and personal views

Robotic pancreaticoduodenectomy and splenopancreatectomy: technical aspects and review of literature

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