title: Robotic distal pancreatectomy.
abstract: BACKGROUND
  A robotic-assisted minimal invasive approach has the potential to overcome the limitations of conventional laparoscopic pancreatectomies. We analyzed the outcomes of robotic-assisted distal pancreatectomies (RDPs) to demonstrate the safety and feasibility of robotic distal pancreas resection, including spleen preservation.
  
  
  METHODS
  We performed a descriptive retrospective analysis of 40 RDPs. Statistical comparisons were performed between two groups of patients undergoing robotic-assisted spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (SDP). Survival analysis was performed using the Kaplan-Meier method.
  
  
  RESULTS
  Of 49 attempted RDPs, 40 were completed with robotic assistance, with a conversion rate of 18.4%. Compared with the published reports of laparoscopic distal pancreatotomy (DP) and robotic DP, the spleen preservation rate (30%), operating time (203 minutes), major complications rate (5%), fistula rate (20%), and length of hospital stay (5 days) were similar in our RDP patients. Also, the perioperative outcomes of the SPDP and SDP groups did not differ significantly. The median survival was 12.5 months for the patients undergoing RDP for pancreatic ductal adenocarcinoma.
  
  
  CONCLUSIONS
  Robotic-assisted distal pancreatectomy, with or without splenic preservation, can be safely performed for lesions of the distal pancreas, with appropriate indications.
authors.affiliation: The Daniel and Gloria Blumenthal Cancer Center, The Valley Hospital, Paramus, NJ, USA; Harlem Hospital Center, Department of Surgery, New York, NY 10037, USA. suman.paritosh@gmail.com.
authors.forename: Paritosh
authors.initials: P
authors.lastname: Suman
authors.affiliation: The Daniel and Gloria Blumenthal Cancer Center, The Valley Hospital, Paramus, NJ, USA.
authors.forename: John
authors.initials: J
authors.lastname: Rutledge
authors.affiliation: The Daniel and Gloria Blumenthal Cancer Center, The Valley Hospital, Paramus, NJ, USA.
authors.forename: Anusak
authors.initials: A
authors.lastname: Yiengpruksawan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D010180:Pancreatectomy / Q000379:methods*; D012189:Retrospective Studies; D012371:Robotics