Robotic pancreatoduodenectomy safe, associated with minimal surgical complications: BMJ

In addition to being practical and reliable, robotic pancreatoduodenectomy (RPD) has a low conversion rate to open surgery, minimal risk of surgical complication, and promotes postoperative recovery of abilities essential for daily life, says an article published in BMC Surgery.

Regarding the viability, security, and possibility of a robotic pancreatoduodenectomy and whether it raises surgical risks, there is no general agreement. By comparing the perioperative data from laparoscopic pancreatoduodenectomy (LPD), open pancreatoduodenectomy (OPD), and RPD performed in our center in recent years, Wei Guo's study sought to evaluate the safety, viability, and logic of RPD.

Retrospectively gathered and evaluated were the clinical data of patients who underwent RPD (n = 32), LPD (n = 21), and OPD (n = 86) in The First Affiliated Hospital of Guangxi Medical University between January 2016 and June 2020.

The key findings of this study were:

1. While the abdominal drainage tube had to be removed, RPD needed less time to do so than OPD did (12.5 days vs. 17.3 days, p = 0.001).

2. The differences between the LPD group and the RPD group were notable because both groups experienced similar amounts of blood loss (482.8 ml vs. 559.5 ml, p > 0.05) and operation time (537.2 min vs. 592.9 min, p = 1.000), but the RPD group experienced a higher activity of daily living score on postoperative day 3 (35.8 vs. 25.7, p = 0.0017) and a lower rate of conversion to OPD.

3. There were no notable variations between the three groups in terms of complications including postoperative pancreatic fistula, abdominal hemorrhage, intra-abdominal infection, bile leakage, reoperation, and perioperative death.

In conclusion, this study reveals that RPD not only delivers significant benefits in terms of short-term operative results without raising the surgical risks, but is also practical and dependable for the excision of benign and malignant tumors. Future research will need to include multiple subjects and large-scale RCTs in order to draw conclusive results.

Reference:

Guo, W., Ye, X., Li, J., Lu, S., Wang, M., Wang, Z., Yao, J., Yu, S., Yuan, G., & He, S. (2022). Comparison of surgical outcomes among open, laparoscopic, and robotic pancreatoduodenectomy: a single-center retrospective study. In BMC Surgery (Vol. 22, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12893-022-01797-4