title: Initial Experience With Robotic Pancreatic Surgery: Technical Feasibility and Oncological Implications.
abstract: Robotic surgery has been introduced in the field of minimally invasive surgery to improve the handling of high-demanding procedures with encouraging results. We aimed to evaluate the clinical safety and the oncological adequacy of robot-assisted pancreatic surgery by analyzing a consecutive series in terms of surgical and oncological outcomes. A total of 53 consecutive cases including 36 pancreatoduodenectomies (PD) and 14 distal pancreatectomies (DP) were evaluated. The overall postoperative morbidity and mortality were 32% and 3.8%, respectively. Radical resection was achieved in 93.7% of PD and 100% of DP, with a mean number of harvested lymph nodes of 29.8 for PD and 20.5 for DP. The 3-year cumulative overall survival was 44.2% and 73.9% for patient with pancreatic ductal adenocarcinoma and nonductal malignancy, respectively. Robotic technology may be useful to reproduce conventional open pancreatic surgery with a minimally invasive approach, overcoming some of the intrinsic limitations of conventional laparoscopy.
authors.affiliation: *Department of Oncology, Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence †International School of Robotic Surgery, Misericordia Hospital, Grosseto, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
authors.forename: Michele
authors.initials: M
authors.lastname: Di Marino
authors.forename: Francesco
authors.initials: F
authors.lastname: Coratti
authors.forename: Giulia
authors.initials: G
authors.lastname: Baldoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerra
authors.forename: Stefano
authors.initials: S
authors.lastname: Amore Bonapasta
authors.forename: Lapo
authors.initials: L
authors.lastname: Bencini
authors.forename: Marco
authors.initials: M
authors.lastname: Farsi
authors.forename: Mario
authors.initials: M
authors.lastname: Annecchiarico
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods / Q000706:statistics & numerical data; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome