Outcomes of Robot‐Assisted Pancreaticoduodenectomy in Patients Older Than 70 Years: A Comparative Study

Buchs, Nicolas; Addeo, Pietro; Bianco, Francesco M.; Gangemi, Antonio; Ayloo, Subhashini; Giulianotti, Pier Cristoforo

doi:10.1007/s00268-010-0650-x

Cited by 63 publications

(91 citation statements)

References 28 publications

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“…Postoperative pancreatic fistula was identified in 9 patients in the laparoscopy-assisted (1-3, 12-18). Recent reports note that complete laparoscopic PD including laparoscopic resection and reconstruction is both technically feasible and safe (3)(4)(5)(6)(7)(8)19). In some cases a minilaparotomy of a few cm is necessary to remove the resected specimen.…”

Section: Resultsmentioning

confidence: 99%

A Non-Randomized Comparative Study of Laparoscopy-Assisted Pancreaticoduodenectomy and Open Pancreaticoduodenectomy

Kuroki¹,

Adachi²,

Okamoto³

et al. 2012

HGE

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Section: Resultsmentioning

confidence: 99%

A Non-Randomized Comparative Study of Laparoscopy-Assisted Pancreaticoduodenectomy and Open Pancreaticoduodenectomy

Kuroki¹,

Adachi²,

Okamoto³

et al. 2012

HGE

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“…No margin was positive. For patients with HCC, the mean surgical margin was 13 mm (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and for colorectal metastases, it was 25 mm (range 5-70) [16]. All these suggest that oncological efficacy can be achieved even in robotic liver resections.…”

Section: Median (Range)mentioning

confidence: 92%

“…The adoption of the state-of-the-art 3D high-definition stereoscopic video system and adjustable magnifying view greatly enhance visualization of the operating field and depth perception compared with conventional laparoscopic or open surgery. These advantages make it attractive alternatives to conventional laparoscopic surgery [1,5,8,11]. However, its high installation and annual maintenance costs make it difficult to justify as an essential acquisition.…”

Section: Median (Range)mentioning

confidence: 99%

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Robotic hepatobiliary and pancreatic surgery: a cohort study

Chan

Tang

Lai

et al. 2011

J Hepato Biliary Pancreat

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Background Robotic surgery has emerged as one of the most promising surgical advances since its launch at the turn of the millennium. Despite its worldwide acceptance in many different surgical specialties, the use of robotic assistance in the field of hepatobiliary and pancreatic (HBP) surgery remains relatively unexplored. This article aims to evaluate the efficacy and outcomes of robotic HBP surgery in a single surgical center. Methods Between May 2009 and December 2010, all patients admitted to our unit for robotic HBP surgery were evaluated. A retrospective analysis of a prospectively maintained database on clinical outcomes was performed. Results There were 55 robotic HBP operations performed during the study period. There were 27 robotic liver resections (left lateral sectionectomies n = 17, left hepatectomy n = 1, other segmentectomies n = 2 and wedge resections n = 7), 12 robotic pancreatic procedures (Whipple's operations n = 8, spleen-preserving distal pancreatectomies n = 2, double bypass n = 1 and cystojejunostomy n = 1) and 16 biliary procedures (biliary enteric bypass n = 9, bile duct exploration and related procedures n = 7). The median postoperative hospital stays for robotic liver resections, biliary procedures and pancreatic operations were 5.5 days (range 3-11 days), 6 days (range 4-11 days) and 12 days (range 6-21 days), respectively. Morbidities for liver resection, biliary procedures and pancreatic operations were 7.4, 18 and 33%, respectively. There was no mortality in our series.Conclusions Robotic surgery is feasible and can be safely performed in patients with complicated HBP pathologies. Further evaluation with clinical trials is required to validate its real benefits.

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“…No clear benefit or advantage over laparoscopy has been established with the application of robotics [51][52][53][54] . It may be reasonable to postulate that the added dexterity of the robotic system may facilitate intracorporeal reconstruction [51][52][53][55][56][57][58][59] .…”

Section: Robotic Pancreatectomymentioning

confidence: 99%

Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

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The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and shortterm oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons' experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. Key words: Laparoscopy; Distal pancreatectomy; Pancreaticoduodenectomy; Robotic pancreatectomy; Enucleation Core tip: This review discusses recent advances in laparoscopic distal pancreatectomy (LDP), minimally invasive pancreaticoduodenectomy (MIPD), and enucleation. Recent studies show that LDP have improved perioperative recovery and equivalent oncologic outcomes. Studies on MIPD demonstrate that it is safe in terms of intra-operative outcomes, post-operative recovery and early oncologic outcomes; however, it requires advanced laparoscopic skills. Laparoscopic enucleation has become the operation of choice for small benign tumours that are away from the main pancreatic duct, especially insulinomas. We also summarize key results in pre-operative, perioperative and post-operative outcomes from contemporary series comparing open and laparoscopic pancreatic resections in the tables.

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Outcomes of Robot‐Assisted Pancreaticoduodenectomy in Patients Older Than 70 Years: A Comparative Study

Abstract: Robot-assisted pancreaticoduodenectomy can be performed safely in elderly patients with comparable mortality, morbidity, and outcomes compared with a younger population. Age alone should not be a contraindication for robotic pancreatic resection.

Cited by 63 publications

References 28 publications

A Non-Randomized Comparative Study of Laparoscopy-Assisted Pancreaticoduodenectomy and Open Pancreaticoduodenectomy

A Non-Randomized Comparative Study of Laparoscopy-Assisted Pancreaticoduodenectomy and Open Pancreaticoduodenectomy

Robotic hepatobiliary and pancreatic surgery: a cohort study

Laparoscopic pancreatectomy: Indications and outcomes

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