Educational step-by-step surgical video about operative technique in robotic pancreaticoduodenectomy (RPD) at University of Illinois at Chicago (UIC): 17 steps standardized technique—Lessons learned since the first worldwide RPD performed in the year 2001

Abstract

Background RPD (Robotic pancreatoduodenectomy) was first performed by P. C. Giulianotti in 2001 (Arch Surg 138 (7): [777][778][779][780][781][782][783][784] 2003). Since then, the complexity and lack of technique standardization has slowed down its widespread utilization. RPD has been increasingly adopted worldwide and in few centres is the preferred apporached approach by certain surgeons. Some large retrospective series are available and data seem to indicate that RPD is safe/feasible, and a valid alternative to the classic open Whipple. Our group has recently described a standardized 17 steps approach to RPD (Giulianotti et al. Surg Endosc 32(10): 4329-4336, 2018). Herin, we present an educational step-by-step surgical video with short technical/operative description to visually exemplify the RPD 17 steps technique. Methods The current project has been approved by our local Institutional Review Board (IRB). We edited a step-by-step video guidance of our RPD standardized technique. The data/video images were collected from a retrospective analysis of a prospectively collected database (IRB approved). The narration and the images describe hands-on operative "tips and tricks" to facilitate the learning/teaching/evaluation process. Results Each of the 17 surgical steps is visually represented and explained to help the in-depth understanding of the relevant surgical anatomy and the specific operative technique. Conclusions Educational videos descriptions like the one herein presented are a valid learning/teaching tool to implement standardized surgical approaches. Standardization is a crucial component of the learning curve. This approach can create more objective and reproducible data which might be more reliably assessed/compared across institutions and by different surgeons. Promising results are arising from several centers about RPD. However, RPD as gold standard-approach is still a matter of debate. Randomized-controlled studies (RCT) are required to better validate the precise role of RPD.Keywords Robotic pancreatoduodenectomy · Whipple procedure · Evidence based surgery · Pancreatic surgery · Pancreatic cancer · Minimally invasive surgery The current short description with video visually illustrates and it is complementary to the technique previously described in the paper published by our group in 2018 [1]. Herein, we epitomize the 17 surgical steps as a complementary adjunct to the associated surgical educational video. and Other Interventional TechniquesElectronic supplementary material The online version of this article (https ://doi.org/10.1007/s0046 4-020-07383 -0) contains supplementary material, which is available to authorized users.

Robotic Whipple for pancreatic ductal and ampullary adenocarcinoma: 10 years experience of a US single‐center

“…On the other hand, RPD is an increasingly widely accepted technique in the treatment of pancreatic head tumors 18,20‐24 . The robotic approach helps to overcome some of the limitations encountered in laparoscopic surgery, especially during the critical steps of the uncinate process dissection and pancreato‐jejunostomy 25 …”

“…Our group was the first one to adopt this technique in 2001, 21 which has been subsequently described in detail 25 …”

Predicting Selection Preference of Robotic Pancreaticoduodenectomy (RPD) in a Chinese Single Center Population: Development and Assessment of a New Predictive Nomogram

“…Since Giulianotti et al successfully performed the first RPD, robotic surgery has been widely applied to pancreatic surgery [40]. Compared with laparoscopic surgery, robotic surgery has comparable perioperative outcomes but more flexibility and reduced learning curve [41][42][43].…”

Long term oncological outcome of laparoscopic techniques in pancreatic cancer

“…Robot-assistance may possibly result in more precise dissection and safer construction of anastomoses. Institutions gaining experience with robot assisted pancreaticoduodenectomy (RPD)[31], underline that standardization of key element of the learning curve of RPD is mandatory[35]. A good model for this has been published from Pittsburgh, where quality outcomes of the first consecutive 200 RPD procedures have been monitored in subgroups of 20 cases, reviewing the learning curve during the implementation phase[36].…”