Abstract

s / Pancreatology 12 (2012) 502–597 550 Introduction: Da Vinci surgical system overcomes most of technical limitations of laparoscopy and provides the unique opportunity to test whether this approach can improve outcomes of pancreatic resections. Aim: In selected patients laparoscopic robot-assisted pancreatic resection can be safely performed. Methods: 105 consecutive robotic pancreatectomies were performed between 10/2008 and 02/2012. There were 40 males and 65 females, with mean age of 58 yrs. 39 patients underwent pancreaticoduodenectomy (PD), 49 distal pancreatectomy (DP), 9 total pancreatectomy, 5 tumor enucleation, 3 central pancreatectomy. Since our activity spans over a 3year period, data were analyzed to verify the learning curve. Results: No conversion were performed. Mean operative time (OT) was 437.8 minutes. In the first year OT was 512 min for PD and 420 for DP. The meannumberof lymphnodes (LN) examinedwas 16.8. Pancreaticfistula (PF) occurred in41%of patients. In the secondyearOTwas596min for PDand402 forDP. The LNexaminedwas16.7. PFoccurred in36.3%ofpatients. In the third year OT was 443 min for PD and 394 for DP. The LN examined was 28.7. PF occurred in 37% of patients. 61 patients were diagnosed with benign or lowgrade tumors, 44 with cancer. Surgical margins were always negative. Postoperative mortality was nil, morbidity 52%. Mean hospital-stay was 16 days. Conclusions: Despite the existence of a learning curve, experienced pancreatic surgeons are not expected to pay to robotics the same price that they would have been asked for by laparoscopy.

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