AI Article Synopsis

  • A new method called robotic pancreatoduodenectomy (RPD) is becoming popular, but it's challenging to start using it safely without on-site experts.
  • A detailed plan was created to help hospitals introduce RPD using online help from experienced doctors.
  • After starting the program, they performed RPD on 68 patients and found that the surgery time got shorter with experience, and most surgeries had excellent results.

Article Abstract

Background: Adoption of robotic pancreatoduodenectomy (RPD) is growing, although there are challenges for safe introduction of this technique, including limitations in on-site expert proctoring. We developed and implemented a structured approach for safe introduction of a new RPD program using virtual collaboration.

Methods: A structured framework for introducing a RPD program was designed; key steps included obtaining additional training, identifying required resources, establishing a dedicated team, and patient safety considerations. Virtual collaboration with a proctor for bidirectional communication was utilized for remote operative guidance. In the initial cohort, perioperative data and postoperative outcomes were extracted from a prospectively maintained database.

Results: From August 2020 to December 2023, 68 patients underwent RPD. The median operative time was 407 min with an estimated blood loss of 150 mL. Median length of stay was 8 days. Negative margins were obtained in 90% of resections. Operative time was significantly shorter in the second half of cases compared to the first (380min vs 441min, p < 0.01) and rate of conversion decreased (6% vs 21%).

Conclusion: The safe initiation of a structured RPD program is feasible through virtual expert collaboration. With careful consideration and an appropriate environment, excellent perioperative outcomes are achievable even for initial cases.

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Source
http://dx.doi.org/10.1016/j.hpb.2024.09.001DOI Listing

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