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J.Jpn. Surg. Soc.. 123(5): 421-428, 2022


Feature topic

CURRENT STATUS OF ROBOTIC DISTAL PANCREATECTOMY

Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Hospital, Tokyo, Japan

Yoshihiro Mise, Akio Saiura

Robotic surgical systems have offer great advantages in minimally invasive pancreatectomy (MIP). In particular, the fine and articulated movements of robotic arms hold enormous potential to expand the indications for MIP for pancreatic cancer. This report focuses on how the robotic approach promotes MIP in patients with pancreatic cancer. From June 2020, MIP was changed from the laparoscopic approach to a robotic one in our institution. In patients with pancreatic cancer of the body or tail, distal pancreatectomy (DP) was indicated when a tumor was not close to the root of the splenic artery or attached to the portal vein. From January 2019 to May 2020 (laparoscopic era), in patients undergoing DP, the rate of MIP was 35% (17/48), while the rate increased to 52% (37/70) from June 2020 to February 2022 (robotic era). From the laparoscopic to the robotic era, the rate of pancreatic cancer patients among those undergoing MIP DP increased from 18% to 53%. Available evidence reveals that robotic DP can be safely performed with a lower incidence of conversion to laparotomy compared with the laparoscopic approach. Further investigation is needed to assess the oncological radicality of robotic MIP.


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