Skip to main content
Log in

Update on Robotic Pancreatic Surgery

  • Robotic Surgery (E Berber, Section Editor)
  • Published:
Current Surgery Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review serves as an update on the status of robotic pancreatic surgery. It will focus on major changes in the adoption, safety, patient selection, and procedural refinements in robotic pancreatic surgery over the past 5 years.

Recent Findings

While the findings of this review support the notion that adoption of robotic pancreatic surgery is growing, it is still challenged by the long learning curve. A curriculum has been constructed and disseminated to address this issue. Furthermore, multiple international meetings have been organized to set helpful recommendations and guidelines.

Summary

Robotic pancreatic surgery is a growing platform that is expected to expand with further advancements in technology and increased adoption of the new generation of Hepato-Pancreato-Biliary Surgeons.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Sheetz KH, Claflin J, Dimick JB. Trends in the adoption of robotic surgery for common surgical procedures. JAMA Netw Open. 2020;3(1):e1918911. https://doi.org/10.1001/jamanetworkopen.2019.18911.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Joyce D, Morris-Stiff G, Falk GA, El-Hayek K, Chalikonda S, Walsh RM. Robotic surgery of the pancreas. World J Gastroenterol. 2014;20(40):14726–32. https://doi.org/10.3748/wjg.v20.i40.14726.

    Article  PubMed  PubMed Central  Google Scholar 

  3. van Hilst J, de Rooij T, Abu Hilal M, Asbun HJ, Barkun J, Boggi U, et al. Worldwide survey on opinions and use of minimally invasive pancreatic resection. HPB (Oxford). 2017;19(3):190–204. https://doi.org/10.1016/j.hpb.2017.01.011.

    Article  Google Scholar 

  4. Asbun HJ, Stauffer JA. Laparoscopic vs open pancreaticoduodenectomy: overall outcomes and severity of complications using the Accordion Severity Grading System. J Am Coll Surg. 2012;215(6):810–9. https://doi.org/10.1016/j.jamcollsurg.2012.08.006.

    Article  PubMed  Google Scholar 

  5. Konstantinidis IT, Ituarte P, Woo Y, Warner SG, Melstrom K, Kim J, et al. Trends and outcomes of robotic surgery for gastrointestinal (GI) cancers in the USA: maintaining perioperative and oncologic safety. Surg Endosc. 2019. https://doi.org/10.1007/s00464-019-07284-x.

    Article  PubMed  PubMed Central  Google Scholar 

  6. • Vollmer CM, Asbun HJ, Barkun J, Besselink MG, Boggi U, Conlon KC, et al. Proceedings of the first international state-of-the-art conference on minimally-invasive pancreatic resection (MIPR). HPB (Oxford). 2017;19(3):171–7. https://doi.org/10.1016/j.hpb.2017.01.015. This is the landmark consensus meeting that discussed important aspects of minimally invasive pancreatic surgery application and challenges of adoption.

  7. Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ. 2001;323(7308):334–6. https://doi.org/10.1136/bmj.323.7308.334.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182(18):E839–E842842. https://doi.org/10.1503/cmaj.090449.

    Article  PubMed  PubMed Central  Google Scholar 

  9. • Liu R, Wakabayashi G, Palanivelu C, Tsung A, Yang K, Goh BKP, et al. International consensus statement on robotic pancreatic surgery. Hepatobiliary Surg Nutr. 2019;8(4):345–60. https://doi.org/10.21037/hbsn.2019.07.08. This is the landmark consensus meeting that discussed important aspects of minimally invasive pancreatic surgery application and challenges of adoption.

  10. Moekotte AL, Rawashdeh A, Asbun HJ, Coimbra FJ, Edil BH, Jarufe N, et al. Safe implementation of minimally invasive pancreas resection: a systematic review. HPB (Oxford). 2019. https://doi.org/10.1016/j.hpb.2019.11.005.

    Article  Google Scholar 

  11. Tam V, Zenati M, Novak S, Chen Y, Zureikat AH, Zeh HJ 3rd, et al. Robotic pancreatoduodenectomy biotissue curriculum has validity and improves technical performance for surgical oncology fellows. J Surg Educ. 2017;74(6):1057–65. https://doi.org/10.1016/j.jsurg.2017.05.016.

    Article  PubMed  Google Scholar 

  12. Hogg ME, Tam V, Zenati M, Novak S, Miller J, Zureikat AH, et al. Mastery-based virtual reality robotic simulation curriculum: the first step toward operative robotic proficiency. J Surg Educ. 2017;74(3):477–85. https://doi.org/10.1016/j.jsurg.2016.10.015.

    Article  PubMed  Google Scholar 

  13. Fernandes E, Elli E, Giulianotti P. The role of the dual console in robotic surgical training. Surgery. 2014;155(1):1–4. https://doi.org/10.1016/j.surg.2013.06.023.

    Article  PubMed  Google Scholar 

  14. Mark Knab L, Zenati MS, Khodakov A, Rice M, Al-Abbas A, Bartlett DL, et al. Evolution of a novel robotic training curriculum in a complex general surgical oncology fellowship. Ann Surg Oncol. 2018;25(12):3445–522. https://doi.org/10.1245/s10434-018-6686-0.

    Article  CAS  PubMed  Google Scholar 

  15. Napoli N, Kauffmann EF, Perrone VG, Miccoli M, Brozzetti S, Boggi U. The learning curve in robotic distal pancreatectomy. Updates Surg. 2015;67(3):257–64. https://doi.org/10.1007/s13304-015-0299-y.

    Article  PubMed  Google Scholar 

  16. Takahashi C, Shridhar R, Huston J, Meredith K. Outcomes associated with robotic approach to pancreatic resections. J Gastrointest Oncol. 2018;9(5):936–41. https://doi.org/10.21037/jgo.2018.08.04.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Benizri EI, Germain A, Ayav A, Bernard JL, Zarnegar R, Benchimol D, et al. Short-term perioperative outcomes after robot-assisted and laparoscopic distal pancreatectomy. J Robot Surg. 2014;8(2):125–32. https://doi.org/10.1007/s11701-013-0438-8.

    Article  PubMed  Google Scholar 

  18. Shakir M, Boone BA, Polanco PM, Zenati MS, Hogg ME, Tsung A, et al. The learning curve for robotic distal pancreatectomy: an analysis of outcomes of the first 100 consecutive cases at a high-volume pancreatic centre. HPB (Oxford). 2015;17(7):580–6. https://doi.org/10.1111/hpb.12412.

    Article  Google Scholar 

  19. Stiles ZE, Dickson PV, Deneve JL, Glazer ES, Dong L, Wan JY, et al. The impact of unplanned conversion to an open procedure during minimally invasive pancreatectomy. J Surg Res. 2018;227:168–77. https://doi.org/10.1016/j.jss.2018.02.028.

    Article  PubMed  Google Scholar 

  20. Klompmaker S, van Zoggel DM, Watkins AA, Eskander MF, Tseng JF, Besselink MG, et al. Nationwide evaluation of patient selection for minimally invasive distal pancreatectomy using American College of Surgeons' National Quality improvement program. Ann Surg. 2017;266(6):1055–61. https://doi.org/10.1097/SLA.0000000000001982.

    Article  PubMed  Google Scholar 

  21. • Asbun HJ, Moekotte AL, Vissers FL, Kunzler F, Cipriani F, Alseidi A, et al. The Miami International Evidence-based guidelines on minimally invasive pancreas resection. Ann Surg. 2020;271(1):1–14. https://doi.org/10.1097/SLA.0000000000003590. This is the landmark consensus meeting that discussed important aspects of minimally invasive pancreatic surgery application and challenges of adoption.

  22. Cai J, Ramanathan R, Zenati MS, Al Abbas A, Hogg ME, Zeh HJ, et al. Robotic pancreaticoduodenectomy is associated with decreased clinically relevant pancreatic fistulas: a propensity-matched analysis. J Gastrointest Surg. 2019. https://doi.org/10.1007/s11605-019-04274-1.

    Article  PubMed  Google Scholar 

  23. Jin JB, Qin K, Li H, Wu ZC, Zhan Q, Deng XX, et al. Robotic enucleation for benign or borderline tumours of the pancreas: a retrospective analysis and comparison from a high-volume centre in Asia. World J Surg. 2016;40(12):3009–200. https://doi.org/10.1007/s00268-016-3655-2.

    Article  PubMed  Google Scholar 

  24. Hamad A, Novak S, Hogg ME. Robotic central pancreatectomy. J Vis Surg. 2017;3:94. https://doi.org/10.21037/jovs.2017.05.13.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Konstantinidis IT, Jutric Z, Eng OS, Warner SG, Melstrom LG, Fong Y, et al. Robotic total pancreatectomy with splenectomy: technique and outcomes. Surg Endosc. 2018;32(8):3691–6. https://doi.org/10.1007/s00464-017-6003-1.

    Article  PubMed  Google Scholar 

  26. Zureikat AH, Nguyen T, Boone BA, Wijkstrom M, Hogg ME, Humar A, et al. Robotic total pancreatectomy with or without autologous islet cell transplantation: replication of an open technique through a minimal access approach. Surg Endosc. 2015;29(1):176–83. https://doi.org/10.1007/s00464-014-3656-x.

    Article  PubMed  Google Scholar 

  27. Galvani CA, Rilo HR, Samame J, Gruessner RW. First fully robotic-assisted total pancreatectomy combined with islet autotransplant for the treatment of chronic pancreatitis: a case report. Pancreas. 2013;42(7):1188–9. https://doi.org/10.1097/MPA.0b013e31827fe875.

    Article  PubMed  Google Scholar 

  28. Hamad A, Zenati MS, Nguyen TK, Hogg ME, Zeh HJ 3rd, Zureikat AH. Safety and feasibility of the robotic platform in the management of surgical sequelae of chronic pancreatitis. Surg Endosc. 2018;32(2):1056–65. https://doi.org/10.1007/s00464-017-6010-2.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Essa M. Aleassa.

Ethics declarations

Conflict of interest

MW and EA declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Robotic Surgery.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aleassa, E.M., Walsh, R.M. Update on Robotic Pancreatic Surgery. Curr Surg Rep 8, 21 (2020). https://doi.org/10.1007/s40137-020-00269-z

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s40137-020-00269-z

Keywords

Navigation