Multicenter outcomes of robotic reconstruction during the early learning curve for minimally-invasive pancreaticoduodenectomy

Watkins, Ammara A.; Kent, Tara S.; Gooding, William E.; Boggi, Ugo; Chalikonda, S.; Kendrick, Michael L.; Walsh, R. Matthew; Zeh, Herbert J.; Moser, A. James

doi:10.1016/j.hpb.2017.08.032

Cited by 62 publications

(49 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have suggested that RPD is associated with a shorter learning curve and decreased open conversion rate compared to LPD, and is a valuable addition to the armamentarium of surgeons embarking on MIPD. The recent multi‐centre study from the United States, which looked at robotic reconstruction during the early learning curve, compared with the open technique showed no difference in anastomotic complications, suggesting that RPD can be adopted safely even during the learning phase. This was unlike the results of several studies on LDP, which suggested that there was an increase in morbidity such as pancreatic fistula over the open approach during the learning curve.…”

Section: Discussionmentioning

confidence: 99%

Initial experience with laparoscopic and robotic surgery for the treatment of periampullary tumours: single institution experience with the first 30 consecutive cases

Goh

Low

Kam

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: Concerns have been raised about the safety of minimally invasive surgery (MIS) for pancreatoduodenectomy (PD) during the early learning phase. In this study, we present our initial experience with MIS for periampullary tumours. Methods: Retrospective review of the first 30 consecutive patients who underwent laparoscopic (LS)/robotic surgery (RS) for periampullary tumours between 2014 and 2017. Results: Twenty-seven patients underwent PD, including three total pancreatectomies (TPs) and three underwent palliative bypasses. Twenty underwent LS, of which 18 were hybrid PDs, including two TPs and two bypasses. Ten patients underwent RS, of which nine were PDs, including one TP and one bypass. Five of 10 RSs were totally MIS procedures. There were four PDs with venous resection, of which three were by RS. There were four (13.3%) open conversions all in the LS cohort. There were five (16.7%) major (>grade 2) morbidities, including three pancreatic fistulas (two grade B and one grade C). There was no 30-day and one (3.3%) 90-day mortality. Comparison between RS and LS demonstrated that RS had a higher likelihood of being completed via totally MIS (five (50%) versus 0, P = 0.002), tended to have a shorter post-operative stay (eight (range 6-36) versus 14.5 (range 6-62) days, P = 0.058) but tended to be associated with a longer operation time (670 (range 500-930) versus 577 (range 235-715) min, P = 0.056). Conclusion: Our initial experience demonstrated that both LS and RS can be safely adopted for the treatment of periampullary tumours. The learning curve for RS seemed to be shorter than LS as we could transition more quickly from hybrid PDs to totally MIS safely. © 2019 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E137-E141 ANZJSurg.com E138 Goh et al.

show abstract

Section: Discussionmentioning

confidence: 99%

Initial experience with laparoscopic and robotic surgery for the treatment of periampullary tumours: single institution experience with the first 30 consecutive cases

Goh

Low

Kam

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…There was no difference in the overall morbidity rate of RPD compared to LPD . Another multicentre study from the United States demonstrated that RPD could be adopted safely with similar overall and anastomotic complications compared to the open approach even during the early learning phase . In contrast, a study on LPD demonstrated that it was associated with a higher morbidity rate compared to the open approach .…”

Section: Discussionmentioning

confidence: 98%

Initial experience with robotic pancreatic surgery in Singapore: single institution experience with 30 consecutive cases

Goh

Low

Lee

et al. 2018

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Although the safety and benefits have been shown in many studies, minimally invasive hepato‐pancreato‐biliary surgery has not been widely adopted for major operations including hemi‐hepatectomy and pancreatoduodenectomy procedures . The steep learning curve of hepatic or pancreatic resections may cause the reluctances to use minimally invasive techniques in this field.…”

Section: Discussionmentioning

confidence: 99%

“…Robotic gastrectomy has been shown to be equally safe in oncologic terms with additional benefits of less blood loss and decreased hospi- Although the safety and benefits have been shown in many studies, 11,31 minimally invasive hepato-pancreato-biliary surgery has not been widely adopted for major operations including hemi-hepatectomy and pancreatoduodenectomy procedures. 32 The steep learning curve of hepatic 33 or pancreatic 34 resections may cause the reluctances to use minimally invasive techniques in this field. In Turkey, utilisation of the robots in hepatic or pancreatic resections seems parallel to general worldwide trend.…”

Section: Discussionmentioning

confidence: 99%

Adoption of robotic technology in Turkey: A nationwide analysis on caseload and platform used

Esen

Aytaç

Ozben

et al. 2018

Robotics Computer Surgery

View full text Add to dashboard Cite

Background Limited data exist regarding adoption of evolving robotic technology in surgery. This study evaluated trends and the current condition of robotic platforms in surgical specialties and general surgical subspecialties. Methods Between January 2013 and December 2017, all robotic operations performed in Turkey were included. Results In the study period, 13 760 robotic operations were performed at 32 hospitals. The median numbers of general surgical procedures were 43and eight cases per hospital and per general surgeon, respectively. The high‐volume general surgeons performed 1734 (81%) of the cases. Forty‐five percent and 55% of the general surgical operations were performed with the Xi and S/Si robots, respectively. Conclusion Use of the Xi platform seems to increase caseload in general surgery operations possibly by facilitating robotic colorectal surgery. Targeting the high‐volume centres and surgeons for further training and implantation of upcoming robotic technology can be more effective in terms of increasing case volume and improving outcomes.

show abstract

Multicenter outcomes of robotic reconstruction during the early learning curve for minimally-invasive pancreaticoduodenectomy

Abstract: These multicenter data during the early learning curve for RA-MIPD do not demonstrate excess anastomotic morbidity compared to open. Further studies are required to determine whether surgeon proficiency and evolving technique improve anastomotic outcomes compared to open.

Cited by 62 publications

References 56 publications

Initial experience with laparoscopic and robotic surgery for the treatment of periampullary tumours: single institution experience with the first 30 consecutive cases

Initial experience with laparoscopic and robotic surgery for the treatment of periampullary tumours: single institution experience with the first 30 consecutive cases

Initial experience with robotic pancreatic surgery in Singapore: single institution experience with 30 consecutive cases

Adoption of robotic technology in Turkey: A nationwide analysis on caseload and platform used

Contact Info

Product

Resources

About