Robotic Pancreatoduodenectomy: Increasing Complexity and Decreasing Complications with Experience: Single-Center Results from 150 Consecutive Patients.

Background: This report describes the authors' experience with 150 consecutive robotic pancreatoduodenectomies.

Methods: The study enrolled 150 consecutive patients who underwent robotic pancreatoduodenectomy between 2018 and 2023. Pre- and intraoperative variables such as age, gender, indication, operation time, diagnosis, and tumor size were analyzed.

STAPLED FASCIAL CLOSURE VS. CONTINUOUS HAND-SEWN SUTURE: EXPERIMENTAL STUDY OF THE ABDOMINAL WALL ON PORCINE MODEL AND HUMAN CADAVER.

Background: One of the primary complications associated with large incisions in abdominal surgery is the increased risk of fascial closure rupture and incisional hernia development. The choice of the fascial closure method and closing with minimal tension and trauma is crucial for optimal results, emphasizing the importance of uniform pressure along the suture line to withstand intra-abdominal pressure.

Aims: To evaluate the resistance to pressure and tension of stapled and sutured hand-sewn fascial closure in the abdominal wall.

Bovine Pericardial Graft for Portomesenteric Reconstruction During Robotic Pancreatoduodenectomy.

Background: Minimally invasive pancreatoduodenectomy (PD) is one of the most complex procedures in oncologic surgery. We present a video of robotic portomesenteric reconstruction with bovine pericardial graft during PD.

Methods: A 52-year-old woman was referred with a mass in the head of the pancreas.

Robotic Hepatic Bisegmentectomy (s4b + s5) and Hilar Lymphadenectomy for Incidental Gallbladder Cancer Using Glissonian Approach.

Background: Gallbladder carcinoma is a rare cancer with a poor prognosis and the most common biliary tract malignancy. This video shows robotic treatment of a patient with incidental gallbladder cancer diagnosed after laparoscopic cholecystectomy. The operation consisted of a robotic bisegmentectomy (liver segments 4b and 5) using a Glissonian approach and a hilar lymphadenectomy.

A new technique of duodenojejunostomy may reduce the rate of delayed gastric emptying after pylorus-preserving pancreatoduodenectomy: The growth factor technique (with video).

Background: Despite various technical modifications, delayed gastric emptying (DGE) is one of the most common complications after pancreatoduodenectomy. DGE results in longer hospital stay, higher cost, lower quality of life, and delay of adjuvant therapy. We have developed a modified duodenojejunostomy technique to reduce the incidence of DGE.

ROBOTIC LIVER RESECTION. REPORT OF THE FIRST 50 CASES.

Background: Robotic surgery has gained growing acceptance in recent years, expanding to liver resection.

Objective: The aim of this paper is to report the experience with our first fifty robotic liver resections.

Methods: This was a single-cohort, retrospective study.

Mesopancreas Excision and Triangle Operation During Robotic Pancreatoduodenectomy.

Background: The retropancreatic space between the superior mesenteric artery, celiac axis, and portal vein is called the mesopancreas. Total mesopancreas excision and skeletonization of both celiac axis and superior mesenteric artery are used to reduce R1 resection in high-risk patients and in those with locally advanced disease. The aim of this study was to present a series of video clips from several patients showing the mesopancreas excision and the triangle operation with a detailed technical description of both techniques with different approaches.

Robotic Resection and Reconstruction of the Superior Mesenteric Vein Without Graft During Pancreatoduodenectomy (with Video).

Background: Pancreatoduodenectomy is the procedure of choice for tumors in the head of the pancreas. Invasion of major vessels is a relative contraindication for minimally invasive approach. We present a video of a robotic resection and reconstruction of the superior mesenteric vein (SMV) without the use of a graft during pancreatoduodenectomy.

Robotic Right Hepatectomy with Portal Vein Thrombectomy for Colorectal Liver Metastasis (with Video).

Background: Hepatectomy is the standard treatment for colorectal liver metastases. However, the high recurrence rate is a persistent problem that occurs in up to 65% of patients. Repeat hepatectomy is a feasible treatment and may offer favorable surviva but is technically demanding so minimally invasive repeat hepatectomy has been used in a few patients.

Robotic Artery-First Approach During Pancreatoduodenectomy.

Background: Surgical resection with adjuvant or neoadjuvant chemotherapy is the only curative modality for treatment of patients with pancreatic and periampullary tumors. With the increasing use of minimally invasive techniques, laparoscopic and robotic pancreatoduodenectomy (PD) has become more common, but laparoscopic artery-first techniques have been described in few studies. The aim of this study is to describe our robotic artery-first technique.

Robotic Resection of Postero-Superior Liver Segments (7,8) (with Video).

Background: Surgical resection is the standard treatment for colorectal liver metastases. Parenchyma-sparing technique should always be attemptedto prevent postoperative liver failure and increase the opportunity to perform repeated resections in cases of recurrent malignancy. Postero-superior liverresection is defined as the anatomical removal of liver segments 7 and 8, however, minimally invasive resection of postero-superior liver segments isconsidered a difficult and complex operation and thus is rarely reported.

Robotic pancreatic resection. Personal experience with 105 cases.

Objective: the first robotic pancreatic resection in Brazil was performed by our team in 2008. Since March 2018, a new policy prompted us to systematically employ the robot in all minimally invasive pancreatic surgery. The aim of this paper is to review our experience with robotic pancreatic resection.

Robotic Resection of Hilar Cholangiocarcinoma.

Background: Hilar cholangiocarcinoma is the most common malignant neoplasm of the biliary tract. Surgical resection is the only curative modality of treatment. The aim of this video is to present a robotic left hepatectomy extended to caudate lobe, combined with bile duct resection, lymphadenectomy, and Roux-en-Y biliary reconstruction.