Background: More complex cases are being performed robotically. This study aims to characterize trends in robotic pancreatoduodenectomy (RPD) over time and assess opportunities for advanced trainees.
Methods: Using the ACS-NSQIP database from 2014 to 2019, PD cases were characterized by operative approach (open-OPN, laparoscopic-LAP, robotic-ROB). Proficiency and postoperative outcomes were described by approach over time.
Results: 24,268 PDs were identified, with the ROB approach increasing from 2.8% to 7.5%. Unplanned conversion increased over time for LAP (27.7-39.0%, p = 0.003) but was unchanged for ROB cases (14.8-14.7%, p = 0.257). Morbidity increased for OPN PD (35.5-36.8%, p = 0.041) and decreased for ROB PD (38.7-30.3%, p = 0.010). Mean LOS was lower in ROB than LAP/OPN (9.5 vs. 10.9 vs. 10.9 days, p < 0.00001). Approximately, 100 AHPBA, SSO, and ASTS fellows are being trained each year in North America; however, only about 5 RPDs are available per trainee per year which is far below that recommended to achieve proficiency.
Conclusion: Over a 6-year period, a significant increase was observed in the use of RPD without a concomitant increase in conversion rates. RPD was associated with decreased morbidity and length of stay. Despite this shift, the number of cases being performed is not adequate for all fellows to achieve proficiency before graduation.
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http://dx.doi.org/10.1007/s00464-022-09469-3 | DOI Listing |
Int J Surg
December 2024
Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Robotic pancreaticoduodenectomy (RPD) is used more commonly, but high-level evidence is still scarce. This meta-analysis aimed to compare the short-term outcomes between RPD and laparoscopic pancreaticoduodenectomy (LPD) using data collected from propensity score-matched (PSM) studies.
Materials And Methods: We searched PubMed, Cochrane Library, Embase, and Web of Science databases for PSM studies comparing RPD and LPD.
Surg Today
December 2024
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Portal annular pancreas (PAP) is an uncommon anomaly in which the pancreatic parenchyma surrounds the portal or superior mesenteric vein. An adequate operative approach is necessary to prevent clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy for PAP. We herein report a case of robotic pancreaticoduodenectomy for PAP.
View Article and Find Full Text PDFAnn Surg Open
December 2024
HPB and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Background: The use of minimally invasive (laparoscopic and robotic) pancreatoduodenectomy (PD) is being increasingly adopted despite the lack of hard evidence to support its utilisation. With recent randomised controlled trials (RCTs) comparing open pancreatoduodenectomy (OPD) with robotic or laparoscopic pancreatoduodenectomy (RPD or LPD), we undertook a network meta-analysis (NMA) comparing all 3 approaches to evaluate comparative outcomes.
Methods: A systematic search of MEDLINE, EMBASE, and Cochrane CENTRAL was conducted up to May 2024 and relevant RCTs were identified.
J Hepatobiliary Pancreat Sci
December 2024
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Background/purpose: The Japanese public health insurance system has recently covered robotic pancreaticoduodenectomy (RPD). This study aimed to review the results of RPD during the introductory period and elucidate its safety and feasibility in Japan.
Methods: Consecutive data of 425 patients who underwent RPD were retrospectively collected from 10 high-volume centers in Japan between April 2020 and September 2022.
Int J Med Robot
December 2024
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming Chiao Tung University, Taipei, Taiwan.
Background: The aim of this study is to assess the impact of obesity on the perioperative outcomes in robotic pancreaticoduodenectomy (RPD), rarely documented.
Methods: A total of 886 patients undergoing RPD or open pancreaticoduodenectomy (OPD) were enroled. These patients were categorised into the obese RPD, non-obese RPD and obese OPD groups.
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