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National Trends in Robotic Pancreas Surgery

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Robotic pancreatic surgery is expanding throughout centers across the country. We investigated national trends in the use and outcomes for robotic-assisted pancreaticoduodenectomy (RPD) and distal pancreatectomy (RDP) for primary pancreatic tumors.

Methods

The National Cancer Database was queried for RPD and RDP performed during three time periods: 2010–2012, 2013–2014, and 2015–2016. These time periods were compared for patient and center factors as well as surgical outcomes.

Results

The use of robotic surgery increased during the study period. Most centers performed a low volume of robotic surgery (RPD, 82% of centers averaged < 1 case/year; RDP, 87% averaged < 1 case/year). From the first to last time period, the proportion of cases performed at academic centers decreased (RPD, 83% to 56%; RDP, 77% to 58%, p < 0.001) while patient characteristics remained largely unchanged. For RPD, improvements in mortality (6.7 to 1.8%, p = 0.013) and lymphadenectomy (18 to 21 nodes, p = 0.035) were observed, with no changes in conversion to open surgery, negative margin resections, or readmissions. For RDP, length of stay decreased (7 to 6 days, p = 0.048), but there were no changes in other outcomes. Compared with academic centers, non-academic centers had equivalent rates of conversion to open surgery, negative margins, and 90-day mortality. On multivariate analysis, there was no difference in survival between academic and non-academic centers.

Discussion

Robotic pancreas surgery is expanding to a greater variety of centers nationwide with preservation of key surgical outcomes. These findings support the continued rigorous training and proliferation of qualified robotic pancreas surgeons going forward.

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Authors and Affiliations

  1. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Richard S. Hoehn, Ibrahim Nassour, Mohamed A. Adam, Alessandro Paniccia & Amer H. Zureikat

  2. UPMC Network Cancer Registry, University of Pittsburgh, Pittsburgh, PA, USA

    Sharon Winters

  3. Division of GI Surgical Oncology, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, 5150 Center Ave., Suite 421, UPMC Cancer Pavilion, Pittsburgh, PA, 15232, USA

    Amer H. Zureikat

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  1. Richard S. Hoehn
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Correspondence to Amer H. Zureikat.

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Hoehn, R.S., Nassour, I., Adam, M.A. et al. National Trends in Robotic Pancreas Surgery. J Gastrointest Surg 25, 983–990 (2021). https://doi.org/10.1007/s11605-020-04591-w

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  • DOI: https://doi.org/10.1007/s11605-020-04591-w

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