Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases

Robotic assisted minimally invasive surgery has been implemented to overcome typical limitations of conventional laparoscopy such as lack of angulation, especially during creation of biliary and pancreatic anastomoses. With this retrospective analysis, we provide our experience with the first 101 co...

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Main Authors: Lea Timmermann, Matthias Biebl, Moritz Schmelzle, Marcus Bahra, Thomas Malinka, Johann Pratschke
Format: Article
Language:English
Published: MDPI AG 2021-01-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/2/229
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author Lea Timmermann
Matthias Biebl
Moritz Schmelzle
Marcus Bahra
Thomas Malinka
Johann Pratschke
author_facet Lea Timmermann
Matthias Biebl
Moritz Schmelzle
Marcus Bahra
Thomas Malinka
Johann Pratschke
author_sort Lea Timmermann
collection DOAJ
description Robotic assisted minimally invasive surgery has been implemented to overcome typical limitations of conventional laparoscopy such as lack of angulation, especially during creation of biliary and pancreatic anastomoses. With this retrospective analysis, we provide our experience with the first 101 consecutive robotic pancreatic resection performed at our center. Distal pancreatectomies (RDP, N = 44), total pancreatectomies (RTP, N = 3) and pancreaticoduodenectomies (RPD, N = 54) were included. Malignancy was found in 45.5% (RDP), 66.7% (RTP) and 61% (RPD). Procedure times decreased from the first to the second half of the cohort for RDP (218 min vs. 128 min, <i>p</i> = 0.02) and RPD (378 min vs. 271 min, <i>p</i> < 0.001). Overall complication rate was 63%, 33% and 66% for RPD, RPT and RDP, respectively. Reintervention and reoperation rates were 41% and 17% (RPD), 33% and 0% (RTP) and 50% and 11.4% (RPD), respectively. The thirty-day mortality rate was 5.6% for RPD and nil for RTP and RDP. Overall complication rate remained stable throughout the study period. In this series, implementation of robotic pancreas surgery was safe and feasible. Final evaluation of the anastomoses through the median retrieval incision compensated for the lack of haptic feedback during reconstruction and allowed for secure minimally invasive resection and reconstruction.
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spelling doaj.art-4b82412e948a4b3dbbcc872af47431f32023-12-03T12:42:50ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-0110222910.3390/jcm10020229Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive CasesLea Timmermann0Matthias Biebl1Moritz Schmelzle2Marcus Bahra3Thomas Malinka4Johann Pratschke5Department of Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 10551 Berlin, GermanyDepartment of Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 10551 Berlin, GermanyDepartment of Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 10551 Berlin, GermanyDepartment of Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 10551 Berlin, GermanyDepartment of Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 10551 Berlin, GermanyDepartment of Surgery, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 10551 Berlin, GermanyRobotic assisted minimally invasive surgery has been implemented to overcome typical limitations of conventional laparoscopy such as lack of angulation, especially during creation of biliary and pancreatic anastomoses. With this retrospective analysis, we provide our experience with the first 101 consecutive robotic pancreatic resection performed at our center. Distal pancreatectomies (RDP, N = 44), total pancreatectomies (RTP, N = 3) and pancreaticoduodenectomies (RPD, N = 54) were included. Malignancy was found in 45.5% (RDP), 66.7% (RTP) and 61% (RPD). Procedure times decreased from the first to the second half of the cohort for RDP (218 min vs. 128 min, <i>p</i> = 0.02) and RPD (378 min vs. 271 min, <i>p</i> < 0.001). Overall complication rate was 63%, 33% and 66% for RPD, RPT and RDP, respectively. Reintervention and reoperation rates were 41% and 17% (RPD), 33% and 0% (RTP) and 50% and 11.4% (RPD), respectively. The thirty-day mortality rate was 5.6% for RPD and nil for RTP and RDP. Overall complication rate remained stable throughout the study period. In this series, implementation of robotic pancreas surgery was safe and feasible. Final evaluation of the anastomoses through the median retrieval incision compensated for the lack of haptic feedback during reconstruction and allowed for secure minimally invasive resection and reconstruction.https://www.mdpi.com/2077-0383/10/2/229robotic assisted surgerypancreatic surgerypancreaticoduodenectomy
spellingShingle Lea Timmermann
Matthias Biebl
Moritz Schmelzle
Marcus Bahra
Thomas Malinka
Johann Pratschke
Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases
Journal of Clinical Medicine
robotic assisted surgery
pancreatic surgery
pancreaticoduodenectomy
title Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases
title_full Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases
title_fullStr Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases
title_full_unstemmed Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases
title_short Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases
title_sort implementation of robotic assistance in pancreatic surgery experiences from the first 101 consecutive cases
topic robotic assisted surgery
pancreatic surgery
pancreaticoduodenectomy
url https://www.mdpi.com/2077-0383/10/2/229
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