title: Recent developments in surgery: minimally invasive approaches for patients requiring pancreaticoduodenectomy.
abstract: Over the past decade, minimally invasive surgery has been introduced as a means to allow manipulation of delicate tissues with outstanding visualization of the surgical field. The purpose of this article is to review the available literature regarding early postoperative outcomes and the technical challenges of minimally invasive pancreaticoduodenectomy, including robotic techniques. Herein, we provide a retrospective review of all published studies in the English literature in which a minimally invasive pancreaticoduodenectomy was performed. The reported advantages of minimally invasive pancreaticoduodenectomy include better visualization, faster recovery time, and decreased length of hospital stay. In cases of robotic approaches, some of the proposed advantages include increased dexterity and a superior ergonomic position for the operating surgeon. To our knowledge, few studies have reported results comparable to open techniques in oncologic outcomes with regard to the number of lymph nodes resected and clear margins obtained. An increasing number of pancreatic resections are being performed using minimally invasive approaches. It remains to be determined if the benefits of this technique outweigh its longer operative times and higher costs.
authors.affiliation: Department of Surgical Oncology, Florida Hospital Orlando, Orlando.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Zenoni
authors.affiliation: Department of Surgical Oncology, Florida Hospital Orlando, Orlando2Department of Surgery, University of Central Florida, Orlando.
authors.forename: J Pablo
authors.initials: JP
authors.lastname: Arnoletti
authors.affiliation: Department of Surgical Oncology, Florida Hospital Orlando, Orlando2Department of Surgery, University of Central Florida, Orlando.
authors.forename: Sebastian G
authors.initials: SG
authors.lastname: de la Fuente
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010149:Postoperative Pain / Q000503:physiopathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D058996:Quality Improvement; D018570:Risk Assessment; D012371:Robotics / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome