Early experience of laparoscopic and robotic hybrid pancreaticoduodenectomy

Kim, Hong Beom; Kim, Jae Ri; Han, Youngmin; Кwon, Wook Hyun; Kim, Sun Whe; Jang, Jin–Young

doi:10.1002/rcs.1814

Cited by 28 publications

(24 citation statements)

References 27 publications

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“…It is debatable whether the superior approach for PD is totally robotic surgery or laparoscopic/robotic hybrid surgery. Fernandes et al reported that a totally robotic approach was superior, whereas other studies reported that a hybrid laparoscopic and robotic approach consisting of laparoscopic dissection and robotic reconstruction was superior . The present study used a hybrid approach; laparoscopic surgery enabled a prompt response and wide range of motion during the dissection phase, while robotic surgery enabled fixed and fine movement during the anastomosis phase.…”

Section: Discussionmentioning

confidence: 76%

“…In the present study, the mean operation time in the robot PD group was 335.6 ± 69.4 min. According to our early experience with 16 patients, the mean operation time was 414.7 ± 47.1 min . Therefore, as more cases were experienced, the operation time was reduced.…”

Section: Discussionmentioning

confidence: 99%

“…Extent of the surgery was not different from that of the open PD. The detailed surgical procedures of robot PD have been described previously . Six ports were inserted for the robot and assistant.…”

Section: Methodsmentioning

confidence: 99%

“…The early experiences of robot‐assisted minimally invasive PD (robot PD) and its feasibility and safety have already been reported . The purpose of the present study was to compare robot PD with conventional open PD in terms of clinical outcomes, safety (including complications), and postoperative pain.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of surgical outcomes between open and robot‐assisted minimally invasive pancreaticoduodenectomy

Kim

Han

Kang

et al. 2017

J Hepato Biliary Pancreat

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of surgical outcomes between open and robot‐assisted minimally invasive pancreaticoduodenectomy

Kim

Han

Kang

et al. 2017

J Hepato Biliary Pancreat

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“…15 However, this study precluded randomised controlled trials 10,11 and several other important cohort studies, limiting validity of their review. [16][17][18][19][20] Hence, this systematic review aims to comprehensively evaluate all current and relevant evidence and perform a network meta-analysis to identify techniques associated with superior peri-operative outcomes in patients undergoing PD using a similar methodology to a recent publication on distal pancreatectomy. 21 In order to include a broader spectrum of surgical approaches, this review will summarise findings of both randomised and non-randomised studies.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and network meta-analysis of different surgical approaches for pancreaticoduodenectomy

Kamarajah

Bundred

Marc

et al. 2020

HPB

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Background: Minimally invasive pancreaticoduodenectomy (MIPD) is a demanding surgical procedure, thus explaining its slow expansion and limited popularity amongst Hepato-Pancreatico-Biliary (HPB) surgeons. However, three main advantages of robotic assisted pancreaticoduodenectomy (PD) including improved dexterity, 3D vision less surgical fatigue, may overcome some of the hurdles and ultimately lead to a wider adoption. This systematic review and network meta-analysis aims to evaluate the current literature on open and MIPD. Methods: A systematic literature search was conducted for studies reporting robotic, laparoscopic and open surgery for PD. Network meta-analysis of intraoperative (operating time, blood loss, transfusion rate), postoperative (overall and major complications, pancreatic fistula, delayed gastric emptying, length of hospital stay) and oncological outcomes (R0 resection, lymphadenectomy) were performed. Results: Sixty-one studies including 62,529 patients were included in the network meta-analysis, of which 3% (n = 2131) were totally robotic (TR) and 10% (n = 6514) were totally laparoscopic (TL). There were no significant differences between surgical techniques for major complications, overall and grade B/C fistula, biliary leak, mortality and R0 resections. Transfusion rates were significantly lower in TR compared to TL and open. Operative time for TR was longer compared with open and TL. Both TL and TR were associated with significantly lower rates of wound infections, pulmonary complications, shorter length of stay and higher lymph nodes examined when compared to open. TR was associated with significantly lower conversion rates than TL. Conclusion: In summary, this network meta-analysis highlights the variability in techniques within MIPD and compares other variations to the conventional open PD. Current evidence appears to demonstrate MIPD, both laparoscopic and robotic techniques are associated with improved rates of surgical site infections, pulmonary complications, and a shorter hospital stay, with no compromise in oncological outcomes for cancer resections.

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ROBOT‐assisted pancreatoduodenectomy in 300 consecutive cases: Annual trend analysis and propensity score‐matched comparison of perioperative and long‐term oncologic outcomes with the open method

Kim

Han

et al. 2021

J Hepato Biliary Pancreat

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Background/Purpose We previously reported perioperative and oncologic outcomes of robot‐assisted pancreatoduodenectomy (RAPD); however, the follow‐up period in RAPD was relatively short, and disease‐matched survival analyses were lacking. Therefore, this study investigated time trends of perioperative and long‐term disease‐matched outcomes of RAPD. Methods Annual clinicopathologic outcomes of 328 patients with RAPD between 2015 and 2020 were analyzed and compared with 929 patients with open PD using the propensity score‐matched (PSM) analysis based on postoperative pancreatic fistula (POPF) risk and oncologic variables in malignant patients. Results Robot‐assisted pancreatoduodenectomy cases increased from 10 (6.3%) in 2015 to 116 (50.2% of total PD) in 2020, with malignancy proportion increasing from 50.0% to 80.2%. POPF risk‐based PSM analysis showed that compared with open PD, RAPD had younger patients (63.7 vs 65.6 years, P = .018), longer operation time (339.1 vs 290.0 min, P < .001); however, estimated blood loss (P = .275), complications (17.1% vs 18.3%, P = .702), and clinically relevant POPF (9.8% vs 11.1%, P = .584) were similar with shorter postoperative hospital stay (10.8 vs 15.6 days, P < .001). In disease and stage‐matched malignant patients, R0 resection (93.9% vs 91.2%, P = .376), total retrieved lymph node (18.2 vs 19.9, P = .058), and 5‐year survival rate (57.3% vs 60.6%, P = .406) were similar between RAPD and open PD, also in pancreatic cancer patients (31.6% vs 26.3%, P = .068). Conclusions Robot‐assisted pancreatoduodenectomy demonstrated similar perioperative outcomes with earlier recovery and equivalent long‐term survival with open PD. RAPD is safe and feasible for periampullary lesions, including pancreatic cancers, and its role will expand in the era of minimally invasive surgery.

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Early experience of laparoscopic and robotic hybrid pancreaticoduodenectomy

Abstract: Hybrid PD is feasible and safe. The learning curve of hybrid surgery, particularly robotic anastomosis, is relatively short.

Cited by 28 publications

References 27 publications

Comparison of surgical outcomes between open and robot‐assisted minimally invasive pancreaticoduodenectomy

Comparison of surgical outcomes between open and robot‐assisted minimally invasive pancreaticoduodenectomy

A systematic review and network meta-analysis of different surgical approaches for pancreaticoduodenectomy

ROBOT‐assisted pancreatoduodenectomy in 300 consecutive cases: Annual trend analysis and propensity score‐matched comparison of perioperative and long‐term oncologic outcomes with the open method

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