The current status and future directions of robotic pancreatectomy

Abstract

Robotic distal pancreatectomy (RDP) and robotic pancreatoduodenectomy (RPD) were first described in 2002 and 2003, respectively. 1,2 Several systematic reviews and cohort studies have subsequently shown that robotic pancreatectomy has better or comparable perioperative outcomes compared with conventional open or laparoscopic pancreatectomy. Therefore, in the future, robot pancreatectomy could become an alternative to conventional surgery; however, its use is still controversial. To promote a better understanding of robotic pancreatectomy, we reviewed its current status and future perspectives. | CURRENT TRENDS IN ROBOTI C PAN CRE ATEC TOMYConsidering the number of studies on robotic pancreatectomy, its use is gradually expanding. However, there have been few reports of its trend of use based on national databases. Recently, Hoehn et al 3

Frailty and surgical outcomes in gastrointestinal cancer: Integration of geriatric assessment and prehabilitation into surgical practice for vulnerable patients

“…57,60 Prehabilitation for at least 4 weeks prior to surgery might be nec- open surgery, in terms of less postoperative pain, early postoperative recovery, lower complications, and mortality rates in resections of gastrointestinal tract [61][62][63][64] and HBP cancers. [65][66][67][68] However, the impact of minimally invasive surgery in frail patients remains uncertain.…”

“…Minimally invasive surgery, including laparoscopic or robotic surgery, has been shown to improve postoperative outcomes, compared to open surgery, in terms of less postoperative pain, early postoperative recovery, lower complications, and mortality rates in resections of gastrointestinal tract 61 , 62 , 63 , 64 and HBP cancers. 65 , 66 , 67 , 68 However, the impact of minimally invasive surgery in frail patients remains uncertain.…”

Robotic instruments outside the surgical field can cause problems: A case of critical bleeding during robotic distal pancreatectomy

“…Robotic surgery is dramatically becoming widespread in the field of pancreatic surgery because of its technical advantages including high optical magnification and articulation of forceps. 1,2 Despite these advantages, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation. It is possible to supplement the sense of touch with visual information within the surgical field, but outside the surgical field, there is no tactile information at all.…”

“…Robotic surgery is dramatically becoming widespread in the field of pancreatic surgery because of its technical advantages including high optical magnification and articulation of forceps 1,2 . Despite these advantages, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation.…”

Surgical Outcomes of Robotic Distal Pancreatectomy Versus Laparoscopic Distal Pancreatectomy at a Hospital in a Sparsely Populated Area

“…Several cohort studies reported by high-volume international centers as well as systematic reviews conclude that robotic distal pancreatectomy (RDP) has better or comparable surgical outcomes as laparoscopic distal pancreatectomy (LDP). [1][2][3][4][5] Hence, it is expected that in the future, RDP rather than LDP will be applied for a tumor located in the pancreatic body or tail. However, local hospitals in Japan not only have fewer experienced surgeons with Japanese hepatobiliary-pancreatic (HBP) certification but also perform fewer pancreatectomies compared with urban hospitals.…”