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British Journal of Surgery
Article . 2013 . Peer-reviewed
License: OUP Standard Publication Reuse
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Feasibility of robotic pancreaticoduodenectomy

Authors: BOGGI, UGO; Signori S.; De Lio N.; Perrone V. G.; VISTOLI, FABIO; Belluomini M.; Cappelli C.; +2 Authors

Feasibility of robotic pancreaticoduodenectomy

Abstract

Abstract Background Laparoscopic pancreaticoduodenectomy is feasible, but requires adaptations to established surgical techniques. The improved dexterity offered by robotic assistance provides the opportunity to see whether laparoscopic pancreaticoduodenectomy can be performed safely when faithfully reproducing the open operation. Methods Patients were selected for robotic pancreaticoduodenectomy when generally suitable for laparoscopy. Obese patients were excluded, and those with pancreatic cancer were highly selected. A prospectively designed database was used for data collection and analysis. Results Of 238 patients undergoing pancreaticoduodenectomy, 34 (14·3 per cent) were operated on robotically. No procedure was converted to conventional laparoscopy or open surgery, despite three patients requiring segmental resection of the superior mesenteric/portal vein and reconstruction. The mean duration of operation was 597 (range 420–960) min. The mean number of lymph nodes retrieved and analysed from patients with neoplasia was 32 (range 15–76). Four patients required blood transfusions and five developed postoperative complications exceeding Clavien–Dindo grade II. There were four grade B pancreatic fistulas. One patient died on postoperative day 40. Excess mean operative cost compared with open resection was €6193. Conclusion Selected patients can safely undergo robotic pancreaticoduodenectomy. The main downsides are high costs and prolonged operating times compared with open resection.

Country
Italy
Keywords

Adult, Aged, 80 and over, Operative Time, Robotics, Length of Stay, Middle Aged, Pancreaticoduodenectomy, Pancreatic Neoplasms, Costs and Cost Analysis, Feasibility Studies, Humans, Laparoscopy, Prospective Studies, Aged

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    188
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 1%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
188
Top 1%
Top 1%
Top 1%
hybrid
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