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J.Jpn. Surg. Soc.. 123(5): 397-402, 2022
INTRODCTION OF ROBOT-ASSISTED PANCREATECTOMY
Robot-assisted pancreaticoduodenectomy (RPD) and distal pancreatectomy (RDP) became eligible for coverage under Japanese health insurance in 2020. A proctor system in addition to strict requirements for the introducing institution and surgeon has been established. We introduced RPD from 2021 and have performed 13 procedures. We adopted a hybrid technique, which involves the use of traditional laparoscopy for dissection and resection followed by reconstruction using a robotic system to prevent prolonged operation time and handle sudden bleeding. The median operation time and blood loss were 511 min and 260 mL, respectively. Two patients had grade B pancreatic fistulas and one had a pulmonary thromboembolism. Establishment of an effective education system, careful patient selection, and safe procedures are necessary for the widespread adoption of robot-assisted pancreatectomy.
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